Provider Demographics
NPI:1740627009
Name:ADULT DAY CARE MA LLC
Entity type:Organization
Organization Name:ADULT DAY CARE MA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EPHRAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:GOTTLIEB
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:978-884-3915
Mailing Address - Street 1:51 VARNUM RD
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-3023
Mailing Address - Country:US
Mailing Address - Phone:978-884-3915
Mailing Address - Fax:
Practice Address - Street 1:51 VARNUM RD
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-3023
Practice Address - Country:US
Practice Address - Phone:978-884-3915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care