Provider Demographics
NPI:1447770524
Name:ADULT DAY HEALTH, INC.
Entity Type:Organization
Organization Name:ADULT DAY HEALTH, INC.
Other - Org Name:BROCKTON ADULT MEDICAL DAY CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFMEISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-846-3779
Mailing Address - Street 1:313 CONGRESS ST FL 5
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02210-1218
Mailing Address - Country:US
Mailing Address - Phone:919-846-3779
Mailing Address - Fax:
Practice Address - Street 1:25 CHRISTY DR
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1813
Practice Address - Country:US
Practice Address - Phone:508-586-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADULT DAY HEALHT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-21
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care