Basic Information
| Provider Information | |||||||||
| NPI: | 1881694503 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAPUANO HOME HEALTH CARE, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 265 BENTON DR STE 201 | ||||||||
| Address2: | |||||||||
| City: | E LONGMEADOW | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010283219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135252124 | ||||||||
| FaxNumber: | 4135255691 | ||||||||
| Practice Location | |||||||||
| Address1: | 265 BENTON DR STE 201 | ||||||||
| Address2: | |||||||||
| City: | E LONGMEADOW | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010283219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135252124 | ||||||||
| FaxNumber: | 4135255691 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | CHATMAN | ||||||||
| AuthorizedOfficialFirstName: | TIARA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4135252124 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | RN | ||||||||
| NPICertificationDate: | 01/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | MA | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 0606693 | 05 | MA | MEDICAID |