Provider Demographics
NPI:1659751931
Name:ADULT DEVELOPMENTAL CENTER, INC
Entity Type:Organization
Organization Name:ADULT DEVELOPMENTAL CENTER, INC
Other - Org Name:ADC
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:ESDRAS
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-431-7108
Mailing Address - Street 1:25 MARLBORO ST
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-3657
Mailing Address - Country:US
Mailing Address - Phone:617-816-7419
Mailing Address - Fax:
Practice Address - Street 1:25 MARLBORO ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-3657
Practice Address - Country:US
Practice Address - Phone:617-816-7419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization