Provider Demographics
NPI:1760867188
Name:LIFEWATCH HOME CARE INC
Entity Type:Organization
Organization Name:LIFEWATCH HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAPHAEL
Authorized Official - Middle Name:CHUKWUGAEKWU
Authorized Official - Last Name:OKOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-910-9204
Mailing Address - Street 1:1210 HYDE PARK AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-2800
Mailing Address - Country:US
Mailing Address - Phone:617-910-9204
Mailing Address - Fax:617-333-9758
Practice Address - Street 1:1210 HYDE PARK AVE STE 2
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-2800
Practice Address - Country:US
Practice Address - Phone:617-910-9204
Practice Address - Fax:617-333-9758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health