Provider Demographics
NPI:1316463110
Name:STEPHCORP
Entity type:Organization
Organization Name:STEPHCORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:V MARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:617-299-1526
Mailing Address - Street 1:380 APPLETON ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-7048
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:380 APPLETON ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-7048
Practice Address - Country:US
Practice Address - Phone:617-266-1526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-14
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health