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General NPI Number Information
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NPI Number | 1538617477
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Entity Type | Organization
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Legal Business Name | OUTER CAPE COMMUNITY OUTREACH
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Dates
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Enumeration Date | 09/20/2016
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 14 TERN RD
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City | SOUTH YARMOUTH
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State | MA
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Zip | 02664-2051
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Country | US
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Telephone | 508-332-6746
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Fax |
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Provider Business Mailing Address
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Address Line | 14 TERN RD
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City | SOUTH YARMOUTH
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State | MA
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Zip | 02664-2051
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Country | US
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Telephone | 508-332-6746
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Fax |
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Authorized Official
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Title or Position | OWER
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Name | MRS. SHEILA AVERNIS KNIGHT
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Credential | CNA.,PCA.,PSA
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Telephone | 508-332-6746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | CNA83659
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License Number State | MA
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