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General NPI Number Information
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NPI Number | 1871949545
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Entity Type | Organization
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Legal Business Name | IMMACULATE HOMECARE SERVICES
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Dates
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Enumeration Date | 05/11/2016
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 800 W CUMMINGS PARK STE 1400
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City | WOBURN
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State | MA
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Zip | 01801-6374
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Country | US
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Telephone | 781-281-8078
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Fax | 781-998-0228
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Provider Business Mailing Address
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Address Line | 800 W CUMMINGS PARK STE 1400
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City | WOBURN
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State | MA
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Zip | 01801-6374
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Country | US
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Telephone | 781-281-8078
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Fax | 781-998-0228
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Authorized Official
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Title or Position | CARE MANAGER
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Name | FAITH GATHINGU
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Credential | RN
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Telephone | 781-787-0993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing 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 | 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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