Provider Demographics
NPI:1316259856
Name:HOME CARE CENTER
Entity type:Organization
Organization Name:HOME CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAVIL
Authorized Official - Middle Name:F
Authorized Official - Last Name:BAKOUSSEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-821-9303
Mailing Address - Street 1:139 E FOXBORO ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-2522
Mailing Address - Country:US
Mailing Address - Phone:617-821-9303
Mailing Address - Fax:800-941-1745
Practice Address - Street 1:139 E FOXBORO ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067-2522
Practice Address - Country:US
Practice Address - Phone:617-821-9303
Practice Address - Fax:800-941-1745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health