Provider Demographics
NPI:1851579031
Name:EZ HOME CARE
Entity Type:Organization
Organization Name:EZ HOME CARE
Other - Org Name:EZ HOMECARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERLYNE
Authorized Official - Middle Name:DENEISE
Authorized Official - Last Name:MAYERS
Authorized Official - Suffix:I
Authorized Official - Credentials:BS BUSINESS
Authorized Official - Phone:617-947-7857
Mailing Address - Street 1:85 ALEXANDER ST
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02125-2727
Mailing Address - Country:US
Mailing Address - Phone:617-427-1682
Mailing Address - Fax:617-442-0377
Practice Address - Street 1:85 ALEXANDER ST
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02125-2727
Practice Address - Country:US
Practice Address - Phone:617-427-1682
Practice Address - Fax:617-442-0377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-09
Last Update Date:2008-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility