Provider Demographics
NPI:1205869575
Name:PRIMARY HOMECARE SPECIALTIES, LLC
Entity type:Organization
Organization Name:PRIMARY HOMECARE SPECIALTIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CELESTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CEFALU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:617-930-7076
Mailing Address - Street 1:75 ADAMS ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-3432
Mailing Address - Country:US
Mailing Address - Phone:617-696-0600
Mailing Address - Fax:617-696-1200
Practice Address - Street 1:75 ADAMS ST
Practice Address - Street 2:SUITE D
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-3432
Practice Address - Country:US
Practice Address - Phone:617-696-0600
Practice Address - Fax:617-696-1200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health