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General NPI Number Information
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NPI Number | 1669462826
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Entity Type | Organization
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Legal Business Name | LIFE CARE AT HOME OF MASSACHUSETTS, INC.
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 12/09/2011
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Provider Practice Location Address
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Address Line | 73 STEVENS ST
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City | EAST TAUNTON
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State | MA
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Zip | 02718-1319
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Country | US
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Telephone | 508-822-6066
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Fax | 508-822-9820
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Provider Business Mailing Address
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Address Line | 3001 KEITH ST NW
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City | CLEVELAND
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State | TN
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Zip | 37312-3713
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Country | US
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Telephone | 423-473-5256
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Fax | 423-339-8356
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Authorized Official
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Title or Position | VP OF FINANCE
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Name | PAMELA RAU
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Credential |
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Telephone | 423-473-5280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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