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NPI 1972475432

NPI 1972475432 : S&M KODAM LLC D/B/A VISITING ANGELS : LEOMINSTER, MA

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General NPI Number Information
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    NPI Number           |    1972475432
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    Entity Type          |    Organization 
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    Legal Business Name  |    S&M KODAM LLC D/B/A VISITING ANGELS 
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Dates
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    Enumeration Date     |    09/23/2025
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    Last Update Date     |    09/23/2025
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Provider Practice Location Address
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    Address Line         |    853 N MAIN ST STE 201 
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    City                 |    LEOMINSTER
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    State                |    MA
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    Zip                  |    01453-1424
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    Country              |    US
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    Telephone            |    978-227-5263
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    853 N MAIN ST STE 201 
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    City                 |    LEOMINSTER
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    State                |    MA
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    Zip                  |    01453-1424
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    Country              |    US
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    Telephone            |    978-227-5263
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DIRECTOR/OWNER
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    Name                 |     SHRAVAN KUMAR  KODAM 
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    Credential           |    
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    Telephone            |    617-750-3858
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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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