Provider Demographics
NPI:1518722065
Name:SULLY ADULT DAY HEALTH LLC.
Entity Type:Organization
Organization Name:SULLY ADULT DAY HEALTH LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:B
Authorized Official - Last Name:SULLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-212-6527
Mailing Address - Street 1:837 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-2941
Mailing Address - Country:US
Mailing Address - Phone:617-212-6527
Mailing Address - Fax:
Practice Address - Street 1:837 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-2941
Practice Address - Country:US
Practice Address - Phone:617-212-6527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care