Organization
NUESTRA CASA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX EYDINOV (ADMINISTRATOR)
(630) 212-9145
Entity
Organization
Contact information
Practice address
64 ROANOKE AVE, WEST SPRINGFIELD, MA 01089-3710
(630) 212-9145
Mailing address
125 LIBERTY ST STE 401, SPRINGFIELD, MA 01103-1109
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/22/2023
Last updated
11/22/2023
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