MEDICARE: TRUE VALLEY HEALTHCARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1225529266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUE VALLEY HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	25 FACTORY PL FL 2
Second Line	:
City	:	CHICOPEE
State	:	MA
Zip	:	01013-4033
Country	:	US
Telephone Number	:	413-687-4951
Fax Number	:

Provider Business Practice Location Address
First Line	:	177 HUNTINGTON AVE STE 1703
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02115-3153
Country	:	US
Telephone Number	:	413-687-4951
Fax Number	:

Authorized Official
Title or Position	:	CO- OWNER
Name	:	VIKTORIYA S PASKONOV
Credential	:	RN
Telephone Number	:	413-687-4951

Provider Enumeration Date	:	05/25/2018
Last Update Date	:	05/25/2018

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