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Organization

STAFFING ON DEMAND

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GIOVANNI CHIMA (COO)
(774) 297-4013
Entity
Organization

Contact information

Practice address
29 LISA DR, BROCKTON, MA 02302-1125
(774) 297-4013
Mailing address
29 LISA DR, BROCKTON, MA 02302-1125
(774) 297-4013

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
261QA0600X
Adult Day Care Clinic/Center
310400000X
Assisted Living Facility
3104A0625X
Assisted Living Facility (Mental Illness)
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
320700000X
Physical Disabilities Residential Treatment Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Enumeration date
10/01/2024
Last updated
07/16/2025
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