Healthcare Provider Details

I. General information

NPI: 1508340910
Provider Name (Legal Business Name): CENTRAL MASS HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2018
Last Update Date: 09/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 W MAIN ST
WEST BROOKFIELD MA
01585-2823
US

IV. Provider business mailing address

19 W MAIN ST
WEST BROOKFIELD MA
01585-2823
US

V. Phone/Fax

Practice location:
  • Phone: 508-612-7525
  • Fax: 774-449-8197
Mailing address:
  • Phone: 508-612-7525
  • 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: NANCY SUE BESARDI
Title or Position: MANAGER
Credential:
Phone: 508-612-7525