Healthcare Provider Details

I. General information

NPI: 1891986188
Provider Name (Legal Business Name): ACCLAIM MSG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 08/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 WINTER ST SUITE 1000
WALTHAM MA
02451-1401
US

IV. Provider business mailing address

1050 WINTER ST SUITE 1000
WALTHAM MA
02451-1401
US

V. Phone/Fax

Practice location:
  • Phone: 781-522-7452
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. CHARLES GOZIE OJOKO
Title or Position: MANAGING PARTNER
Credential:
Phone: 781-522-7452