Healthcare Provider Details

I. General information

NPI: 1043026578
Provider Name (Legal Business Name): URBANSF INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2024
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 COPPERWOOD DR
STOUGHTON MA
02072-1440
US

IV. Provider business mailing address

135 COPPERWOOD DR
STOUGHTON MA
02072-1440
US

V. Phone/Fax

Practice location:
  • Phone: 617-962-5705
  • Fax:
Mailing address:
  • Phone: 617-962-5705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CHUKWUDI UDEH
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 617-962-5705