Healthcare Provider Details

I. General information

NPI: 1477610384
Provider Name (Legal Business Name): OTRADA ADULT DAY HEALTH CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 2ND AVE
NEEDHAM MA
02494-2810
US

IV. Provider business mailing address

185 2ND AVE
NEEDHAM MA
02494-2810
US

V. Phone/Fax

Practice location:
  • Phone: 781-433-9855
  • Fax:
Mailing address:
  • Phone: 781-433-9855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number261QA0600X
License Number StateMA

VIII. Authorized Official

Name: PEARL MORGOVSKY
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 781-433-9855