Provider Demographics
NPI:1184213928
Name:CONVENIENT CARE AT HOME LLC
Entity Type:Organization
Organization Name:CONVENIENT CARE AT HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHINWE
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-847-2860
Mailing Address - Street 1:45 DAN RD STE 125
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2852
Mailing Address - Country:US
Mailing Address - Phone:508-847-2860
Mailing Address - Fax:508-348-9983
Practice Address - Street 1:45 DAN RD STE 125
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2852
Practice Address - Country:US
Practice Address - Phone:508-847-2860
Practice Address - Fax:508-348-9983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health