1427492669 NPI number — ATTENTIVE HOME CARE, INC.

Table of content: MR. JAKE RICHARD WOOD C.P., F.A.A.O.P. (NPI 1134211915)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427492669 NPI number — ATTENTIVE HOME CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATTENTIVE HOME CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427492669
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
354 FRONT ST
Provider Second Line Business Mailing Address:
SUITE 3
Provider Business Mailing Address City Name:
MARION
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02738-1533
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-748-1811
Provider Business Mailing Address Fax Number:
508-748-1823

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
354 FRONT ST
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
MARION
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02738-1533
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-748-1811
Provider Business Practice Location Address Fax Number:
508-748-1823
Provider Enumeration Date:
04/18/2013

Additional Information

Authorized Official

Authorized Official Last Name:
BRITTO
Authorized Official First Name:
SANDRA
Authorized Official Middle Name:
JEAN
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
508-748-1811

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  E038504 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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