Provider Demographics
NPI:1538463518
Name:ABBEY RD HOME CARE SERVICES INC
Entity Type:Organization
Organization Name:ABBEY RD HOME CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:RNP, MS
Authorized Official - Phone:617-293-0250
Mailing Address - Street 1:1613 BLUE HILL AVE
Mailing Address - Street 2:STE. 301
Mailing Address - City:MATTAPAN
Mailing Address - State:MA
Mailing Address - Zip Code:02126-2123
Mailing Address - Country:US
Mailing Address - Phone:617-298-4400
Mailing Address - Fax:617-298-2100
Practice Address - Street 1:1613 BLUE HILL AVE
Practice Address - Street 2:STE. 301
Practice Address - City:MATTAPAN
Practice Address - State:MA
Practice Address - Zip Code:02126-2123
Practice Address - Country:US
Practice Address - Phone:617-298-4400
Practice Address - Fax:617-298-2100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAT2YK253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care