Provider Demographics
NPI:1598215998
Name:IDEAL CAREGIVERS OF MASSACHUSETTS LLC
Entity Type:Organization
Organization Name:IDEAL CAREGIVERS OF MASSACHUSETTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:JUMBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-306-8605
Mailing Address - Street 1:115 STATE ST
Mailing Address - Street 2:SUIT 502
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01103-1984
Mailing Address - Country:US
Mailing Address - Phone:413-306-8605
Mailing Address - Fax:
Practice Address - Street 1:115 STATE ST
Practice Address - Street 2:SUIT 502
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-1984
Practice Address - Country:US
Practice Address - Phone:413-306-8605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253J00000XAgenciesFoster Care Agency