Healthcare Provider Details

I. General information

NPI: 1376406975
Provider Name (Legal Business Name): PASSPORT TO JOY ADULT DAY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 FERRY ST STE E-1
BRADFORD MA
01835-7441
US

IV. Provider business mailing address

15 MULDOON DR
HUDSON NH
03051-5231
US

V. Phone/Fax

Practice location:
  • Phone: 978-364-1173
  • Fax:
Mailing address:
  • Phone: 978-364-1173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE MARIE TEJEDA
Title or Position: CEO/OWNER
Credential: RB
Phone: 978-364-1173