Provider Demographics
NPI:1578818845
Name:LONGEVITY CARE, INC.
Entity Type:Organization
Organization Name:LONGEVITY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUDMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:COSTIV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-916-1060
Mailing Address - Street 1:1320 CENTRE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2400
Mailing Address - Country:US
Mailing Address - Phone:617-916-1060
Mailing Address - Fax:617-916-2682
Practice Address - Street 1:1320 CENTRE ST STE 200
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-2400
Practice Address - Country:US
Practice Address - Phone:617-916-1060
Practice Address - Fax:617-323-0680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-23
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care