Provider Demographics
NPI:1982190542
Name:TO-SHANKEL HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:TO-SHANKEL HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:UCHE
Authorized Official - Middle Name:K
Authorized Official - Last Name:IWOBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-332-2556
Mailing Address - Street 1:62 TEMI RD
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-3049
Mailing Address - Country:US
Mailing Address - Phone:857-251-2229
Mailing Address - Fax:
Practice Address - Street 1:62 TEMI RD
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-3049
Practice Address - Country:US
Practice Address - Phone:857-251-2229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-06
Last Update Date:2020-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health