=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942306881
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALL CARE ADULT DAY HEALTH CENTER AT NORTH VILLAGE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2006
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20 SHEILA AVE
-----------------------------------------------------
City | NORTH CHELMSFORD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01863-1448
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-251-0367
-----------------------------------------------------
Fax | 978-251-0382
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20 SHEILA AVE
-----------------------------------------------------
City | NORTH CHELMSFORD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01863-1448
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-251-0367
-----------------------------------------------------
Fax | 978-251-0382
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CEO
-----------------------------------------------------
Name | MR. SHAWN POTTER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 781-598-2454
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA0600X
-----------------------------------------------------
Taxonomy Name | Adult Day Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------