Provider Demographics
NPI:1669179123
Name:EB 365 SERVICES LLC
Entity type:Organization
Organization Name:EB 365 SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BOUBKEUR
Authorized Official - Middle Name:
Authorized Official - Last Name:BARAKATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-217-2900
Mailing Address - Street 1:966 PARK ST STE B5
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-3650
Mailing Address - Country:US
Mailing Address - Phone:781-217-2900
Mailing Address - Fax:
Practice Address - Street 1:966 PARK ST STE B5
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-3650
Practice Address - Country:US
Practice Address - Phone:781-217-2900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing CareGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty