Provider Demographics
NPI:1093739583
Name:JACS OPS I INC
Entity Type:Organization
Organization Name:JACS OPS I INC
Other - Org Name:EPOCH SENIOR HEALTHCARE OF MELROSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PFAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-891-0777
Mailing Address - Street 1:51 SAWYER ROAD
Mailing Address - Street 2:STE 500 EPOCH SENIOR LIVING INC
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453
Mailing Address - Country:US
Mailing Address - Phone:781-891-0777
Mailing Address - Fax:781-647-0697
Practice Address - Street 1:15 GREEN ST
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176
Practice Address - Country:US
Practice Address - Phone:781-665-3950
Practice Address - Fax:781-665-9059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0924482Medicaid
MA225007AMedicare Oscar/Certification