=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740410992
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SKILLED HOMECARE SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/22/2009
-----------------------------------------------------
Last Update Date | 07/22/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 391 PLEASANT ST
-----------------------------------------------------
City | LEICESTER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01524-1221
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-987-8802
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 391 PLEASANT ST
-----------------------------------------------------
City | LEICESTER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01524-1221
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-987-8802
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CEO
-----------------------------------------------------
Name | MRS. MELROSE LAHOOD
-----------------------------------------------------
Credential | FNP-BC, GNP-BC,CRNI
-----------------------------------------------------
Telephone | 978-987-8802
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251F00000X
-----------------------------------------------------
Taxonomy Name | Home Infusion Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------