Provider Demographics
NPI:1477839132
Name:PATRIOT ELDER CARE INC.
Entity Type:Organization
Organization Name:PATRIOT ELDER CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-479-4545
Mailing Address - Street 1:1261 FURNACE BROOK PARKWAY
Mailing Address - Street 2:SUITE 22
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169
Mailing Address - Country:US
Mailing Address - Phone:617-302-2481
Mailing Address - Fax:617-472-6947
Practice Address - Street 1:1261 FURNACE BROOK PARKWAY
Practice Address - Street 2:SUITE 22
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169
Practice Address - Country:US
Practice Address - Phone:617-302-2481
Practice Address - Fax:617-472-6947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-26
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
313M00000X
MA4SVE313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility