Provider Demographics
NPI:1609985225
Name:BROOKFIELD ADULT DAY CARE INC
Entity Type:Organization
Organization Name:BROOKFIELD ADULT DAY CARE INC
Other - Org Name:BH NEW BEDFORD ADH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-948-7383
Mailing Address - Street 1:51 SUMMER STREET
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-1833
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:397 COUNTY STREET
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-4998
Practice Address - Country:US
Practice Address - Phone:508-997-9396
Practice Address - Fax:508-990-3336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1905244Medicaid