Provider Demographics
NPI:1144100926
Name:PASSIONATE CARE ADULT FOSTER CARE
Entity type:Organization
Organization Name:PASSIONATE CARE ADULT FOSTER CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:EHIKHAMHEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:857-399-5097
Mailing Address - Street 1:30 EASTBROOK RD STE 402
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-2086
Mailing Address - Country:US
Mailing Address - Phone:857-399-5097
Mailing Address - Fax:781-326-0707
Practice Address - Street 1:30 EASTBROOK RD STE 402
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-2086
Practice Address - Country:US
Practice Address - Phone:857-399-5097
Practice Address - Fax:781-326-0707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency