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General NPI Number Information
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NPI Number | 1548660491
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Entity Type | Organization
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Legal Business Name | BLUE MOUNTAIN HOMECARE SERVICES
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Dates
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Enumeration Date | 08/28/2014
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Last Update Date | 08/28/2014
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Provider Practice Location Address
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Address Line | 74 CAPEN ST
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City | DORCHESTER
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State | MA
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Zip | 02124-4213
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Country | US
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Telephone | 857-247-0217
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 240033
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City | DORCHESTER
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State | MA
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Zip | 02124-0001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/CFO
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Name | NATALIE MICHEL
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Credential |
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Telephone | 857-247-0217
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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 |
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License Number State |
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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 |
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License Number State |
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