Provider Demographics
NPI:1770628729
Name:CAPEWAY ADULT DAY HEALTH CENTER, INC
Entity Type:Organization
Organization Name:CAPEWAY ADULT DAY HEALTH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAKE
Authorized Official - Middle Name:A
Authorized Official - Last Name:COSME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-985-9076
Mailing Address - Street 1:81 WELBY RD
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-1118
Mailing Address - Country:US
Mailing Address - Phone:508-985-9076
Mailing Address - Fax:508-985-9026
Practice Address - Street 1:81 WELBY RD
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-1118
Practice Address - Country:US
Practice Address - Phone:508-985-9076
Practice Address - Fax:508-985-9026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
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
MA1902938Medicaid