Healthcare Provider Details

I. General information

NPI: 1912412412
Provider Name (Legal Business Name): MERCY ADULT DAY HEALTH OF WESTFIELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2017
Last Update Date: 12/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 CLIFTON ST
WESTFIELD MA
01085-3304
US

IV. Provider business mailing address

481 DALGREEN PL
HENDERSON NV
89012-4525
US

V. Phone/Fax

Practice location:
  • Phone: 413-568-0555
  • Fax: 413-568-5978
Mailing address:
  • Phone: 406-647-2980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberDD0P-005
License Number StateMA

VIII. Authorized Official

Name: MS. ANNE MARIE LEWIS
Title or Position: VICE PRESIDENT OPERATIONS
Credential:
Phone: 406-647-2980