Provider Demographics
NPI:1003934928
Name:DUCHARME ESTATES LTD
Entity Type:Organization
Organization Name:DUCHARME ESTATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMELO-DUCHARME
Authorized Official - Suffix:
Authorized Official - Credentials:MED MBADM
Authorized Official - Phone:508-883-2066
Mailing Address - Street 1:25 FEDERAL ST
Mailing Address - Street 2:
Mailing Address - City:BLACKSTONE
Mailing Address - State:MA
Mailing Address - Zip Code:01504-1327
Mailing Address - Country:US
Mailing Address - Phone:508-883-2066
Mailing Address - Fax:508-883-0360
Practice Address - Street 1:25 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:BLACKSTONE
Practice Address - State:MA
Practice Address - Zip Code:01504-1327
Practice Address - Country:US
Practice Address - Phone:508-883-2066
Practice Address - Fax:508-883-0360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1904787310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1904787OtherMA. PROVIDER NUMBER