Healthcare Provider Details

I. General information

NPI: 1356649529
Provider Name (Legal Business Name): MINAIE ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2011
Last Update Date: 12/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 CONCORD STREET
PAWTUCKET RI
02860
US

IV. Provider business mailing address

301 CONCORD STREET
PAWTUCKET RI
02860
US

V. Phone/Fax

Practice location:
  • Phone: 781-454-6919
  • Fax:
Mailing address:
  • Phone: 781-454-6919
  • 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: MR. JEAN DANIEL DESJARDINS
Title or Position: CEO
Credential:
Phone: 781-454-6919