Provider Demographics
NPI:1467847319
Name:CLARITY OF MIND ADULT DAY PROGRAM
Entity Type:Organization
Organization Name:CLARITY OF MIND ADULT DAY PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MILKA
Authorized Official - Middle Name:
Authorized Official - Last Name:FONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-733-5694
Mailing Address - Street 1:46 GREENTREE LN
Mailing Address - Street 2:UNIT 23
Mailing Address - City:S WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-2055
Mailing Address - Country:US
Mailing Address - Phone:774-526-7440
Mailing Address - Fax:
Practice Address - Street 1:46 GREENTREE LN
Practice Address - Street 2:UNIT 23
Practice Address - City:S WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-2055
Practice Address - Country:US
Practice Address - Phone:774-526-7440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care