Healthcare Provider Details

I. General information

NPI: 1427793587
Provider Name (Legal Business Name): MASSBAY ADULT FOSTER CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2022
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 1ST AVE STE 127-5
PEABODY MA
01960-4959
US

IV. Provider business mailing address

2 1ST AVE STE 127-5
PEABODY MA
01960-4959
US

V. Phone/Fax

Practice location:
  • Phone: 781-888-1568
  • Fax:
Mailing address:
  • Phone: 781-888-1568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: KATERINA BALINT
Title or Position: ADMINISTRATOR
Credential:
Phone: 781-888-1568