Provider Demographics
NPI:1679324263
Name:EUREKA ADULT FOSTER CARE LLC
Entity type:Organization
Organization Name:EUREKA ADULT FOSTER CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NYAIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-831-8370
Mailing Address - Street 1:11 FOSTER ST STE 206
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1760
Mailing Address - Country:US
Mailing Address - Phone:508-831-8370
Mailing Address - Fax:
Practice Address - Street 1:11 FOSTER ST STE 206
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1760
Practice Address - Country:US
Practice Address - Phone:508-831-8370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency