Provider Demographics
NPI:1588235881
Name:GOMES, LINETTE RAMOS (HOME HEALTH AGENCY)
Entity Type:Individual
Prefix:
First Name:LINETTE
Middle Name:RAMOS
Last Name:GOMES
Suffix:
Gender:F
Credentials:HOME HEALTH AGENCY
Other - Prefix:
Other - First Name:HOME
Other - Middle Name:HEALTH
Other - Last Name:SERVICES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:HOME HEALTH AGENCY
Mailing Address - Street 1:114 FORD ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-2711
Mailing Address - Country:US
Mailing Address - Phone:774-273-1852
Mailing Address - Fax:
Practice Address - Street 1:114 FORD ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2711
Practice Address - Country:US
Practice Address - Phone:774-273-1852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-07
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACCHT2472R0900X
MA227755251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No2472R0900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherRenal Dialysis