Healthcare Provider Details

I. General information

NPI: 1396190096
Provider Name (Legal Business Name): DASA HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2016
Last Update Date: 04/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 PARK AVE STE 1101A
WORCESTER MA
01609
US

IV. Provider business mailing address

255 PARK AVE STE 1101A
WORCESTER MA
01609-1978
US

V. Phone/Fax

Practice location:
  • Phone: 508-459-3272
  • Fax:
Mailing address:
  • Phone: 508-459-3272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SADIQUE NSIAH
Title or Position: PRESIDENT
Credential: LPN
Phone: 774-578-7088