| NPI | 1407280118 |
|---|---|
| Doing Business As | EXECUTIVE HOME DETOX |
| Entity Type | Organization |
| Authorized Contact | WILLIAM PAUL CARRICK President 781-439-2603 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251J00000X Nursing Care (Licence: MA 156015) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: NY 22583743) |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2013-08-29 |