Healthcare Provider Details

I. General information

NPI: 1700710910
Provider Name (Legal Business Name): CRANBERRY HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 E GROVE ST STE 4
MIDDLEBORO MA
02346-1844
US

IV. Provider business mailing address

43 E GROVE ST STE 4
MIDDLEBORO MA
02346-1844
US

V. Phone/Fax

Practice location:
  • Phone: 508-946-2200
  • Fax: 508-946-2201
Mailing address:
  • Phone: 508-946-2200
  • Fax: 508-946-2201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: CLAYTON SAMUELS
Title or Position: OWNER
Credential:
Phone: 508-946-2200