Provider Demographics
NPI:1033674650
Name:SOLEY LEVE ADULT DAY HEALTH
Entity Type:Organization
Organization Name:SOLEY LEVE ADULT DAY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RISVEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAINTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-247-8483
Mailing Address - Street 1:61 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4137
Mailing Address - Country:US
Mailing Address - Phone:617-905-0341
Mailing Address - Fax:617-419-1129
Practice Address - Street 1:61 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4137
Practice Address - Country:US
Practice Address - Phone:617-905-0341
Practice Address - Fax:617-419-1129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA001348324OtherCORPORATION DIVISION ID NUMBER OF SECRETARY OF THE COMMONWEALTH MASSACHUSETTS