Provider Demographics
NPI:1194966929
Name:CLASSIC HOME CARE INC.
Entity type:Organization
Organization Name:CLASSIC HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:THERESA
Authorized Official - Last Name:OSBAHR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:978-741-2000
Mailing Address - Street 1:92 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3068
Mailing Address - Country:US
Mailing Address - Phone:978-741-2000
Mailing Address - Fax:978-741-2009
Practice Address - Street 1:92 JACKSON ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-3068
Practice Address - Country:US
Practice Address - Phone:978-741-2000
Practice Address - Fax:978-741-2009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7431251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care