Organization
PRIORITY HOME CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TEKUM FOMUM PENTOCOSTER (DIRECTOR)
(617) 323-2276
Entity
Organization
Contact information
Practice address
17 POPLAR STREET, SUITE 4, ROSLINDALE, MA 02131-4302
(617) 323-2276
(617) 323-2294
Mailing address
17 POPLAR ST, SUITE 4, ROSLINDALE, MA 02131-2505
(617) 323-2276
(617) 323-2494
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
7373
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7373
MA PERSONAL CARE, HOMEMAKER LICENSE
MA
Enumeration date
01/23/2008
Last updated
08/18/2008
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