Provider Demographics
NPI:1346601093
Name:ALLSTATE HOME CARE,INC
Entity Type:Organization
Organization Name:ALLSTATE HOME CARE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BOLISLAV
Authorized Official - Middle Name:
Authorized Official - Last Name:GUSEYNOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-436-8980
Mailing Address - Street 1:5 CABOT PL
Mailing Address - Street 2:1
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-4624
Mailing Address - Country:US
Mailing Address - Phone:781-436-8980
Mailing Address - Fax:
Practice Address - Street 1:5 CABOT PLACE.
Practice Address - Street 2:#1
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072
Practice Address - Country:US
Practice Address - Phone:781-436-8980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS85699946253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency