Provider Demographics
NPI:1053379388
Name:CARE ALTERNATIVES OF MASSACHUSETTS, LLC
Entity type:Organization
Organization Name:CARE ALTERNATIVES OF MASSACHUSETTS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YEWANDE
Authorized Official - Middle Name:
Authorized Official - Last Name:EFODILI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-931-9068
Mailing Address - Street 1:65 JACKSON DR
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-3516
Mailing Address - Country:US
Mailing Address - Phone:908-931-9068
Mailing Address - Fax:908-931-9698
Practice Address - Street 1:352 BELMONT ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-1008
Practice Address - Country:US
Practice Address - Phone:508-229-8390
Practice Address - Fax:508-229-8435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7LTY251G00000X
251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA7LTYOtherSTATE LICENSE NUMBER
MA0601250Medicaid
MA7LTYOtherSTATE LICENSE NUMBER