Healthcare Provider Details

I. General information

NPI: 1982943387
Provider Name (Legal Business Name): ABC HOME & HEALTHCARE PROFESSIONALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2013
Last Update Date: 02/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 ALBION ST
WAKEFIELD MA
01880-3122
US

IV. Provider business mailing address

233 ALBION ST
WAKEFIELD MA
01880-3122
US

V. Phone/Fax

Practice location:
  • Phone: 781-245-1880
  • Fax: 781-245-3288
Mailing address:
  • Phone: 781-245-1880
  • Fax: 781-245-3288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberNONE
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberNONE
License Number StateMA

VIII. Authorized Official

Name: JOAN M LEPORE
Title or Position: CFO
Credential:
Phone: 781-245-1880