Provider Demographics
NPI:1841745551
Name:POLARIS HOME CARE SYSTEMS, LLC
Entity type:Organization
Organization Name:POLARIS HOME CARE SYSTEMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TYRONE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-657-5977
Mailing Address - Street 1:245 RIVER ST APT 320
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-3299
Mailing Address - Country:US
Mailing Address - Phone:413-657-5977
Mailing Address - Fax:
Practice Address - Street 1:245 RIVER ST APT 320
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-3299
Practice Address - Country:US
Practice Address - Phone:413-657-5977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-23
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health