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General NPI Number Information
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NPI Number | 1558587584
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Entity Type | Organization
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Legal Business Name | MAINSTAY SUPPORTIVE HOUSING AND HOME CARE, INC.
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 100 BELLINGHAM ST
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City | CHELSEA
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State | MA
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Zip | 02150-3358
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Country | US
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Telephone | 617-884-6333
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Fax | 617-884-3247
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Provider Business Mailing Address
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Address Line | 29 CRAFTS ST STE 260
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City | NEWTON
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State | MA
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Zip | 02458-1396
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Country | US
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Telephone | 617-789-4500
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Fax | 617-789-5750
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Authorized Official
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Title or Position | PROGRAM ADMINISTRATOR
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Name | KATHRYN SODERHOLM
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Credential | MPH
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Telephone | 781-697-4662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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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 | 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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