=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972912186
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAREGIVER HOMECARE SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/13/2014
-----------------------------------------------------
Last Update Date | 09/24/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17 CHURCH ST
-----------------------------------------------------
City | BLACKSTONE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01504
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-271-5574
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17 CHURCH ST
-----------------------------------------------------
City | BLACKSTONE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01504-1630
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-271-5574
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CHRISTEN AUGER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 508-271-5574
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------