Provider Demographics
NPI:1689069924
Name:STAGE ONE HOME CARE AND STAFFING
Entity Type:Organization
Organization Name:STAGE ONE HOME CARE AND STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FESTO
Authorized Official - Middle Name:
Authorized Official - Last Name:LUGOLOBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-204-6104
Mailing Address - Street 1:24 CRSCENT STREET
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24 CRSCENT STREET
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453
Practice Address - Country:US
Practice Address - Phone:857-204-6104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STAHE ONE SERVICES BOSTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251300000X, 347C00000X
MA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251300000XAgenciesLocal Education Agency (LEA)
No347C00000XTransportation ServicesPrivate Vehicle