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General NPI Number Information
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NPI Number | 1093260705
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Entity Type | Organization
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Legal Business Name | PATRIOT ELDER CARE
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 08/23/2016
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Provider Practice Location Address
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Address Line | 1261 FURNACE BROOK PKWY SUITE #21
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City | QUINCY
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State | MA
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Zip | 02169-4721
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Country | US
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Telephone | 617-479-4545
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Fax |
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Provider Business Mailing Address
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Address Line | 1261 FURNACE BROOK PKWY SUITE #21
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City | QUINCY
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State | MA
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Zip | 02169-4721
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Country | US
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Telephone | 617-479-4545
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ALEJANDRA ACCARDI
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Credential | MD
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Telephone | 617-479-4545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 4SVE
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License Number State | MA
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