Healthcare Provider Details

I. General information

NPI: 1801931324
Provider Name (Legal Business Name): HENRY C. NEVINS HOME FOR THE AGED ALZHEIMER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 INGALLS CT
METHUEN MA
01844-3712
US

IV. Provider business mailing address

12 INGALLS CT
METHUEN MA
01844-3712
US

V. Phone/Fax

Practice location:
  • Phone: 978-682-7611
  • Fax: 978-794-0279
Mailing address:
  • Phone: 978-682-7611
  • Fax: 978-794-0279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHARON ANNE WALSH
Title or Position: FINANCIAL ANALYST
Credential:
Phone: 978-682-7611