Provider Demographics
NPI:1740918549
Name:DICHARL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:DICHARL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/STAFF
Authorized Official - Prefix:
Authorized Official - First Name:DILYS
Authorized Official - Middle Name:
Authorized Official - Last Name:POKU-MENSAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-593-8170
Mailing Address - Street 1:571 BOSTON TURNPIKE STE 3
Mailing Address - Street 2:#1050
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-5977
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1067 MAIN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-2406
Practice Address - Country:US
Practice Address - Phone:508-593-8170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-10
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty