Provider Demographics
NPI:1750831681
Name:SWEET HOME CORP
Entity Type:Organization
Organization Name:SWEET HOME CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VASILY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOKAREV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-536-7741
Mailing Address - Street 1:112 NARRAGANSETT BLVD
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01013-2120
Mailing Address - Country:US
Mailing Address - Phone:413-536-7741
Mailing Address - Fax:
Practice Address - Street 1:112 NARRAGANSETT BLVD
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01013-2120
Practice Address - Country:US
Practice Address - Phone:413-536-7741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home