Provider Demographics
NPI:1639489453
Name:AMERICAN FAMILY HEALTH CARE GROUP SERVICES CO.
Entity Type:Organization
Organization Name:AMERICAN FAMILY HEALTH CARE GROUP SERVICES CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDOUARD
Authorized Official - Middle Name:SEHOULA
Authorized Official - Last Name:BEUGRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-605-2549
Mailing Address - Street 1:66 MYRTLE ST FL 3
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-4410
Mailing Address - Country:US
Mailing Address - Phone:781-605-2549
Mailing Address - Fax:
Practice Address - Street 1:66 MYRTLE STREET 3RD FLOOR
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-4410
Practice Address - Country:US
Practice Address - Phone:781-605-2549
Practice Address - Fax:781-605-2547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health