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General NPI Number Information
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NPI Number | 1659067668
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Entity Type | Organization
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Legal Business Name | IMMACULATE HOME HEALTH CARE SERVICES
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Dates
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Enumeration Date | 04/12/2023
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 21 HARDING RD
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City | ROSLINDALE
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State | MA
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Zip | 02131-3808
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Country | US
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Telephone | 857-488-6610
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Fax |
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Provider Business Mailing Address
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Address Line | 21 HARDING RD
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City | ROSLINDALE
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State | MA
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Zip | 02131-3808
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Country | US
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Telephone | 857-488-6610
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NADIA MILDRED WOGHIREN
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Credential | PMHNP, MSN
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Telephone | 857-488-6610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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