Provider Demographics
NPI:1720237167
Name:MAS HOME CARE
Entity Type:Organization
Organization Name:MAS HOME CARE
Other - Org Name:MAS HOME CARE OF NH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-232-0972
Mailing Address - Street 1:156 HARVEY RD
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-7449
Mailing Address - Country:US
Mailing Address - Phone:603-232-0972
Mailing Address - Fax:
Practice Address - Street 1:1243 MINERAL SPRING AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-4636
Practice Address - Country:US
Practice Address - Phone:401-312-1160
Practice Address - Fax:401-724-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health