Healthcare Provider Details
I. General information
NPI: 1285416859
Provider Name (Legal Business Name): UNITED HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/18/2023
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
360 W BOYLSTON ST. SUITE 209
WESTBOYLSTON MA
01583
US
IV. Provider business mailing address
360 W BOYLSTON ST. SUITE 209
WESTBOYLSTON MA
01583
US
V. Phone/Fax
- Phone: 508-847-4980
- Fax:
- Phone: 508-595-8443
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253J00000X |
| Taxonomy | Foster Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 311ZA0620X |
| Taxonomy | Adult Care Home Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CAROL
NGUNJIRI
Title or Position: CEO
Credential: RN, BSN
Phone: 508-847-4980