Provider Demographics
NPI:1710375472
Name:GOOD SHEPHERD SERVICES LLC
Entity Type:Organization
Organization Name:GOOD SHEPHERD SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LUXON
Authorized Official - Middle Name:
Authorized Official - Last Name:RATEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-308-7799
Mailing Address - Street 1:103 SELWYN RD
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-5185
Mailing Address - Country:US
Mailing Address - Phone:781-308-7799
Mailing Address - Fax:
Practice Address - Street 1:103 SELWYN RD
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-5185
Practice Address - Country:US
Practice Address - Phone:781-308-7799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-05
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health