Healthcare Provider Details

I. General information

NPI: 1578725040
Provider Name (Legal Business Name): HOME STAFF, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 06/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 MILLBROOK ST
WORCESTER MA
01606-2836
US

IV. Provider business mailing address

40 MILLBROOK ST
WORCESTER MA
01606-2836
US

V. Phone/Fax

Practice location:
  • Phone: 508-755-4600
  • Fax: 508-421-4758
Mailing address:
  • Phone: 508-755-4600
  • Fax: 508-421-4758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number7092
License Number StateMA

VII. Legacy identifiers

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

VIII. Authorized Official

Name: MRS. ANGELA ROCHELEAU
Title or Position: CHEIF EXECUTIVE OFFICER
Credential:
Phone: 508-755-4600