Healthcare Provider Details

I. General information

NPI: 1679324263
Provider Name (Legal Business Name): EUREKA ADULT FOSTER CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 FOSTER ST STE 206
WORCESTER MA
01608-1760
US

IV. Provider business mailing address

11 FOSTER ST STE 210
WORCESTER MA
01608-1760
US

V. Phone/Fax

Practice location:
  • Phone: 508-831-8370
  • Fax:
Mailing address:
  • Phone: 508-831-8370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. PATRICIA NYAIRO
Title or Position: CEO
Credential:
Phone: 508-831-8370