Healthcare Provider Details

I. General information

NPI: 1922553981
Provider Name (Legal Business Name): CARIDAD INDEPENDENT LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2016
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S MAIN ST
RANDOLPH MA
02368-4896
US

IV. Provider business mailing address

101 S MAIN ST
RANDOLPH MA
02368-4896
US

V. Phone/Fax

Practice location:
  • Phone: 781-885-7882
  • Fax:
Mailing address:
  • Phone: 885-991-0110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARVEL LAROSE
Title or Position: PRESIDENT
Credential:
Phone: 857-991-0110