Provider Demographics
NPI:1417710211
Name:MY HOME CARE
Entity type:Organization
Organization Name:MY HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ESPERANZA
Authorized Official - Last Name:VICTORINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-441-2847
Mailing Address - Street 1:92 MCCABE AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02861-1042
Mailing Address - Country:US
Mailing Address - Phone:401-441-2847
Mailing Address - Fax:
Practice Address - Street 1:500 BROAD ST
Practice Address - Street 2:
Practice Address - City:CENTRAL FALLS
Practice Address - State:RI
Practice Address - Zip Code:02863-2844
Practice Address - Country:US
Practice Address - Phone:401-441-2847
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health