Healthcare Provider Details

I. General information

NPI: 1649300526
Provider Name (Legal Business Name): SPECIALTY HOME CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 ATWOOD AVE STE 105
JOHNSTON RI
02919-4930
US

IV. Provider business mailing address

1395 ATWOOD AVE STE 105
JOHNSTON RI
02919-4930
US

V. Phone/Fax

Practice location:
  • Phone: 401-455-1111
  • Fax: 401-455-0220
Mailing address:
  • Phone: 401-455-1111
  • Fax: 401-455-0220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberHCP02438
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANNE MARIE SHATTUCK
Title or Position: PRESIDENT/ADMINISTRATOR
Credential:
Phone: 508-366-1330