Provider Demographics
NPI:1871824052
Name:CAREPROVIDERS OF BLACKSTONE VALLEY, LLC
Entity Type:Organization
Organization Name:CAREPROVIDERS OF BLACKSTONE VALLEY, LLC
Other - Org Name:ELDERWOOD HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROKES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:508-579-9505
Mailing Address - Street 1:176 WORCESTER PROVIDENCE TPKE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SUTTON
Mailing Address - State:MA
Mailing Address - Zip Code:01590-1901
Mailing Address - Country:US
Mailing Address - Phone:508-579-9505
Mailing Address - Fax:508-377-4578
Practice Address - Street 1:176 WORCESTER PROVIDENCE TPKE
Practice Address - Street 2:SUITE 205
Practice Address - City:SUTTON
Practice Address - State:MA
Practice Address - Zip Code:01590-1901
Practice Address - Country:US
Practice Address - Phone:508-579-9505
Practice Address - Fax:508-377-4578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-27
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA227526Medicare Oscar/Certification