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General NPI Number Information
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NPI Number | 1740070291
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Entity Type | Organization
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Legal Business Name | FUENTES COMMUNITY SERVICES
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 59 MERRIAM AVE STE 201
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City | LEOMINSTER
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State | MA
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Zip | 01453-3158
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Country | US
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Telephone | 774-530-1938
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Fax |
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Provider Business Mailing Address
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Address Line | 59 MERRIAM AVE STE 201
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City | LEOMINSTER
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State | MA
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Zip | 01453-3158
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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 | OWNER
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Name | MR. KEVIN KARANJA
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Credential | MAT
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Telephone | 774-530-1938
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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 | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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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 | 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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