Provider Demographics
NPI:1770228496
Name:STAY HOME AFC
Entity Type:Organization
Organization Name:STAY HOME AFC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTON
Authorized Official - Middle Name:
Authorized Official - Last Name:PUKHOVITSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-828-8887
Mailing Address - Street 1:1707 GAR HWY
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-3901
Mailing Address - Country:US
Mailing Address - Phone:978-828-8887
Mailing Address - Fax:
Practice Address - Street 1:1707 GAR HWY
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-3901
Practice Address - Country:US
Practice Address - Phone:978-828-8887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty