=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538554225
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOUTH SHORE ELDER CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2015
-----------------------------------------------------
Last Update Date | 03/31/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 800 HINGHAM ST SUITE 203S
-----------------------------------------------------
City | ROCKLAND
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02370-1074
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-681-3545
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 800 HINGHAM ST STE 203S
-----------------------------------------------------
City | ROCKLAND
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02370-1067
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-681-3545
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | JAMES JEAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 781-681-3545
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------