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General NPI Number Information
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NPI Number | 1821339714
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Entity Type | Organization
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Legal Business Name | HOME QARE
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Dates
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Enumeration Date | 03/03/2013
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Last Update Date | 05/29/2013
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Provider Practice Location Address
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Address Line | 303 WYMAN ST STE 300
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City | WALTHAM
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State | MA
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Zip | 02451-1255
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Country | US
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Telephone | 888-878-4966
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 920679
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City | NEEDHAM
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State | MA
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Zip | 02492-0008
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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. DHAFIR JOHNSON
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Credential | BSHS, CRA, CHHA, CST
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Telephone | 888-878-4966
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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 | MA
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