Provider Demographics
NPI:1417607441
Name:JERUSALEM HOME CARE LLC
Entity Type:Organization
Organization Name:JERUSALEM HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAMAGER
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:MORISSET
Authorized Official - Last Name:PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-535-8028
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:508-455-0118
Mailing Address - Fax:508-455-0118
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:508-455-0118
Practice Address - Fax:508-455-0118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health