Provider Demographics
NPI:1609248285
Name:ORANGE DAWN CARE
Entity Type:Organization
Organization Name:ORANGE DAWN CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILSON
Authorized Official - Middle Name:W
Authorized Official - Last Name:KIRIUNGI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-825-3178
Mailing Address - Street 1:34 MERRIFIELD ST
Mailing Address - Street 2:APT 3
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3019
Mailing Address - Country:US
Mailing Address - Phone:508-825-3178
Mailing Address - Fax:
Practice Address - Street 1:34 MERRIFIELD ST
Practice Address - Street 2:APT 3
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3019
Practice Address - Country:US
Practice Address - Phone:508-825-3178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2297041251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health