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General NPI Number Information
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NPI Number | 1407220304
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Entity Type | Organization
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Legal Business Name | LADY OF FATIMA HOMECARE SERVICES LLC
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Dates
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Enumeration Date | 11/17/2015
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Last Update Date | 11/17/2015
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Provider Practice Location Address
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Address Line | 207 PLEASANT ST
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City | DRACUT
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State | MA
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Zip | 01826-4817
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Country | US
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Telephone | 978-609-4016
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Fax | 978-957-9698
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Provider Business Mailing Address
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Address Line | 207 PLEASANT ST
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City | DRACUT
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State | MA
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Zip | 01826-4817
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Country | US
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Telephone | 978-609-4016
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Fax | 978-957-9698
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | FATIMA JAITEH
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Credential |
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Telephone | 978-609-4016
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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 | 001190136
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 001190136
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License Number State | MA
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