Provider Demographics
NPI:1811512825
Name:MINDSET HOMECARE LLC
Entity type:Organization
Organization Name:MINDSET HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CISSY
Authorized Official - Middle Name:
Authorized Official - Last Name:NAKANWAGI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:508-292-9428
Mailing Address - Street 1:PO BOX 2072
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01888-0172
Mailing Address - Country:US
Mailing Address - Phone:508-292-9428
Mailing Address - Fax:
Practice Address - Street 1:7 TOTMAN DR APT 9
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-5455
Practice Address - Country:US
Practice Address - Phone:508-292-9428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MINDSET HOME CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA235060OtherRN LICENSE