Healthcare Provider Details

I. General information

NPI: 1588219935
Provider Name (Legal Business Name): DILLARD HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2019
Last Update Date: 08/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

756 WASHINGTON ST STE D
STOUGHTON MA
02072-2976
US

IV. Provider business mailing address

20 ROCHE BROTHERS WAY # 6-273
NORTH EASTON MA
02356-1030
US

V. Phone/Fax

Practice location:
  • Phone: 508-294-8722
  • Fax: 781-459-7799
Mailing address:
  • Phone: 508-294-8722
  • Fax: 781-459-7799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ANNETTE DILLARD
Title or Position: PRESIDENT
Credential: CNA, HHA
Phone: 508-294-8722