Provider Demographics
NPI:1467162859
Name:ADVINIACARE NEWBURYPORT LLC
Entity Type:Organization
Organization Name:ADVINIACARE NEWBURYPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CATERINA
Authorized Official - Middle Name:MINA
Authorized Official - Last Name:LABELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-904-9139
Mailing Address - Street 1:10 CABOT PL
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-4600
Mailing Address - Country:US
Mailing Address - Phone:508-904-9139
Mailing Address - Fax:
Practice Address - Street 1:180 LOW ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3519
Practice Address - Country:US
Practice Address - Phone:978-465-5361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility