Provider Demographics
NPI:1215562020
Name:WAY MAKER HOME CARE LLC
Entity Type:Organization
Organization Name:WAY MAKER HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-850-5925
Mailing Address - Street 1:66 HANOVER ST STE 101
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-2230
Mailing Address - Country:US
Mailing Address - Phone:617-850-5925
Mailing Address - Fax:
Practice Address - Street 1:66 HANOVER ST STE 101
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-2230
Practice Address - Country:US
Practice Address - Phone:617-850-5925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-12
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care