Provider Demographics
NPI:1073016705
Name:NORTH SHORE UNITED HOME CARE LLC
Entity Type:Organization
Organization Name:NORTH SHORE UNITED HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THERESE
Authorized Official - Middle Name:PELAGIE
Authorized Official - Last Name:BONOK
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:978-259-8534
Mailing Address - Street 1:205 HIGHLAND AVE UNIT 1107
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2743
Mailing Address - Country:US
Mailing Address - Phone:857-364-9645
Mailing Address - Fax:
Practice Address - Street 1:205 HIGHLAND AVE UNIT 1107
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2743
Practice Address - Country:US
Practice Address - Phone:857-364-9645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care