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General NPI Number Information
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NPI Number | 1841084910
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Entity Type | Organization
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Legal Business Name | NTERYCARE HOME HEALTHCARE
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Dates
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Enumeration Date | 04/05/2025
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Last Update Date | 04/05/2025
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Provider Practice Location Address
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Address Line | 94 PINE ST
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City | BROCKTON
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State | MA
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Zip | 02302-3616
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Country | US
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Telephone | 508-586-0491
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Fax |
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Provider Business Mailing Address
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Address Line | 20 ROCHE BROTHERS WAY UNIT 6272
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City | NORTH EASTON
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State | MA
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Zip | 02356-1030
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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 | FOUNDER/ OWNER
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Name | DIARRY SISSOKHO
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Credential | RN
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Telephone | 508-930-9083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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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