Provider Demographics
NPI:1932723871
Name:GREATCOMFORTHOMECARE
Entity Type:Organization
Organization Name:GREATCOMFORTHOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAFFOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-253-5994
Mailing Address - Street 1:39 BLENDALL ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-1740
Mailing Address - Country:US
Mailing Address - Phone:774-253-5994
Mailing Address - Fax:508-556-2054
Practice Address - Street 1:39 BLENDALL ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-1740
Practice Address - Country:US
Practice Address - Phone:774-253-5994
Practice Address - Fax:508-556-2054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-06
Last Update Date:2020-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health