Provider Demographics
NPI:1083069116
Name:POLYCLINIC AFC., LLC
Entity Type:Organization
Organization Name:POLYCLINIC AFC., LLC
Other - Org Name:FAMILY CARE AFC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZABARSKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-584-1249
Mailing Address - Street 1:127 HARTWELL ST
Mailing Address - Street 2:UNIT 800
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-2467
Mailing Address - Country:US
Mailing Address - Phone:617-584-1249
Mailing Address - Fax:
Practice Address - Street 1:127 HARTWELL ST
Practice Address - Street 2:UNIT 800
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-2467
Practice Address - Country:US
Practice Address - Phone:617-584-1249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency