Provider Demographics
NPI:1275832867
Name:ENRICHED ADULT DAY CARE, INC.
Entity Type:Organization
Organization Name:ENRICHED ADULT DAY CARE, INC.
Other - Org Name:ENRICHED ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NEREE
Authorized Official - Middle Name:
Authorized Official - Last Name:THEMISTOCLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-444-6389
Mailing Address - Street 1:409 COLUMBIA ROAD
Mailing Address - Street 2:UNIT 600
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339
Mailing Address - Country:US
Mailing Address - Phone:781-524-1688
Mailing Address - Fax:781-524-1657
Practice Address - Street 1:409 COLUMBIA ROAD
Practice Address - Street 2:UNIT 600
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339
Practice Address - Country:US
Practice Address - Phone:781-524-1688
Practice Address - Fax:781-524-1657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN261124261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care