Healthcare Provider Details

I. General information

NPI: 1750916912
Provider Name (Legal Business Name): HARVARD JOYFUL ADULT HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2020
Last Update Date: 03/09/2020
Certification Date: 03/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 AYER RD
HARVARD MA
01451-1158
US

IV. Provider business mailing address

200 AYER RD
HARVARD MA
01451-1158
US

V. Phone/Fax

Practice location:
  • Phone: 781-999-2641
  • Fax: 781-281-7412
Mailing address:
  • Phone: 781-999-2641
  • Fax: 781-281-7412

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: LUCY SU
Title or Position: DIRECTOR
Credential:
Phone: 781-999-2641