Healthcare Provider Details

I. General information

NPI: 1366610347
Provider Name (Legal Business Name): BOSTON ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2008
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 DORCHESTER AVE
DORCHESTER MA
02125-1501
US

IV. Provider business mailing address

1225 DORCHESTER AVENUE
DORCHESTER MA
02125
US

V. Phone/Fax

Practice location:
  • Phone: 617-265-0200
  • Fax: 617-265-2300
Mailing address:
  • Phone: 617-265-0200
  • Fax: 617-265-2300

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: MR. DAVID VO
Title or Position: OWNER
Credential:
Phone: 617-265-0200