Provider Demographics
NPI:1245601269
Name:BAY COVE HUMAN SERVICES, INC.
Entity Type:Organization
Organization Name:BAY COVE HUMAN SERVICES, INC.
Other - Org Name:KIT CLARK SENIOR SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, SVP FINANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:HORGOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-371-3007
Mailing Address - Street 1:66 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2002
Mailing Address - Country:US
Mailing Address - Phone:617-371-3062
Mailing Address - Fax:
Practice Address - Street 1:645 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02124-3510
Practice Address - Country:US
Practice Address - Phone:617-371-3062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAY COVE HUMAN SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-16
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care