Organization
CHEACARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS ITACY (OWNER/MANAGER)
(617) 271-3745
Entity
Organization
Contact information
Practice address
23 LOCUST ST, BROCKTON, MA 02301-1630
(617) 271-3745
Mailing address
23 LOCUST ST, BROCKTON, MA 02301-1630
(617) 271-3745
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
RN2269332
MA
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
06/12/2015
Last updated
06/25/2015
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