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General NPI Number Information
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NPI Number | 1073016705
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Entity Type | Organization
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Legal Business Name | NORTH SHORE UNITED HOME CARE LLC
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Dates
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Enumeration Date | 03/08/2018
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Last Update Date | 03/08/2018
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Provider Practice Location Address
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Address Line | 205 HIGHLAND AVE UNIT 1107
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City | SALEM
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State | MA
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Zip | 01970-2743
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Country | US
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Telephone | 857-364-9645
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Fax |
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Provider Business Mailing Address
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Address Line | 205 HIGHLAND AVE UNIT 1107
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City | SALEM
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State | MA
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Zip | 01970-2743
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Country | US
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Telephone | 857-364-9645
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | THERESE PELAGIE BONOK
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Credential | RN, BSN.
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Telephone | 978-259-8534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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