Healthcare Provider Details

I. General information

NPI: 1457803686
Provider Name (Legal Business Name): RELIABLE HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2016
Last Update Date: 11/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35A HOUGHTON STRRET
WORCESTER MA
01604
US

IV. Provider business mailing address

35A HOUGHTON STREET
WORCESTER MA
01604
US

V. Phone/Fax

Practice location:
  • Phone: 774-243-4219
  • Fax:
Mailing address:
  • Phone: 774-243-4219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name: HENRIETTA MEFORCHOM NKONGCHU
Title or Position: PROGRAM COORDINATOR
Credential:
Phone: 774-243-4219