Provider Demographics
NPI:1477914448
Name:ADULT FOSTER & DISABLED CARE SERVICES
Entity Type:Organization
Organization Name:ADULT FOSTER & DISABLED CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-794-9266
Mailing Address - Street 1:30 FEDERAL STREET
Mailing Address - Street 2:302
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970
Mailing Address - Country:US
Mailing Address - Phone:978-224-2285
Mailing Address - Fax:978-224-2289
Practice Address - Street 1:30 FEDERAL STREET
Practice Address - Street 2:302
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970
Practice Address - Country:US
Practice Address - Phone:978-224-2285
Practice Address - Fax:978-224-2289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health