=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548121940
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AFFIRMED HOME CARE MASSACHUSETTS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/24/2025
-----------------------------------------------------
Last Update Date | 11/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24 CRESCENT ST STE 401E
-----------------------------------------------------
City | WALTHAM
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02453-4360
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-423-5611
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 70 W 36TH ST FL 6
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10018-8007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-423-5611
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF COMPLIANCE
-----------------------------------------------------
Name | KAITLIN EDWARDS
-----------------------------------------------------
Credential | LPN
-----------------------------------------------------
Telephone | 917-970-0126
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------