Healthcare Provider Details

I. General information

NPI: 1811140437
Provider Name (Legal Business Name): INTERCARE GROUP, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 10/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 W MAIN ST # A
NORTON MA
02766-1243
US

IV. Provider business mailing address

184 W MAIN ST # A
NORTON MA
02766-1243
US

V. Phone/Fax

Practice location:
  • Phone: 774-430-3341
  • Fax: 610-552-9807
Mailing address:
  • Phone: 774-430-3341
  • Fax: 610-552-9807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. RITA V KELLEHER
Title or Position: VICE PRESIDENT
Credential:
Phone: 508-369-4130