Provider Demographics
NPI:1619202140
Name:AT HOME PERSONAL CARE
Entity Type:Organization
Organization Name:AT HOME PERSONAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JERRY
Authorized Official - Last Name:GALATIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:617-416-9591
Mailing Address - Street 1:25 INDIAN ROCK RD
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01778-3837
Mailing Address - Country:US
Mailing Address - Phone:781-996-3618
Mailing Address - Fax:781-996-3619
Practice Address - Street 1:25 INDIAN ROCK RD
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MA
Practice Address - Zip Code:01778-3837
Practice Address - Country:US
Practice Address - Phone:781-996-3618
Practice Address - Fax:781-996-3619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care