Provider Demographics
NPI:1588030399
Name:MASSCARE HEALTH SYSTEMS LLC
Entity Type:Organization
Organization Name:MASSCARE HEALTH SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATHEW
Authorized Official - Middle Name:M
Authorized Official - Last Name:KIIO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:888-589-9340
Mailing Address - Street 1:599 CANAL ST SUITE 4 EAST 9
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840-1244
Mailing Address - Country:US
Mailing Address - Phone:888-589-9340
Mailing Address - Fax:888-589-9340
Practice Address - Street 1:599 CANAL ST SUITE 4 EAST 9
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1244
Practice Address - Country:US
Practice Address - Phone:888-589-9340
Practice Address - Fax:888-589-9340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-15
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health