1942504204 NPI number — BLACKSTONE VALLEY HOME CARE SPECIALISTS INC.

Table of content: (NPI 1942504204)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942504204 NPI number — BLACKSTONE VALLEY HOME CARE SPECIALISTS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BLACKSTONE VALLEY HOME CARE SPECIALISTS 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:
1942504204
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
110 ELM ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILLBURY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01527-2641
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-865-1223
Provider Business Mailing Address Fax Number:
508-865-6828

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 ELM ST
Provider Second Line Business Practice Location Address:
SUITE #7
Provider Business Practice Location Address City Name:
MILLBURY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01527-2641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-865-1223
Provider Business Practice Location Address Fax Number:
508-865-6828
Provider Enumeration Date:
12/30/2010

Additional Information

Authorized Official

Authorized Official Last Name:
FINNE
Authorized Official First Name:
ANGELA
Authorized Official Middle Name:
KAY
Authorized Official Title or Position:
OWNER/CEO
Authorized Official Telephone Number:
508-865-1223

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  7364 , 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)





Copyright © 2007-2025 www.npivalidator.com