Healthcare Provider Details

I. General information

NPI: 1104583848
Provider Name (Legal Business Name): NUEVO DIA ADULT DAY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2021
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 AMORY ST
ROXBURY MA
02119-1051
US

IV. Provider business mailing address

152 WEST ST
BOSTON MA
02136-1529
US

V. Phone/Fax

Practice location:
  • Phone: 617-959-6593
  • Fax:
Mailing address:
  • Phone: 617-959-6593
  • Fax:

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: CARISSA FIGUEROA
Title or Position: OWNER
Credential:
Phone: 617-230-7189