Provider Demographics
NPI:1174652119
Name:HIGHLAND ADULT DAY CARE, INC.
Entity Type:Organization
Organization Name:HIGHLAND ADULT DAY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-676-1023
Mailing Address - Street 1:56 N MAIN ST
Mailing Address - Street 2:ROOM 319
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-2132
Mailing Address - Country:US
Mailing Address - Phone:508-676-1023
Mailing Address - Fax:
Practice Address - Street 1:1197 ROBESON ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5562
Practice Address - Country:US
Practice Address - Phone:508-673-1290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1900994Medicaid