MEDICARE: ADVENTCARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619158532
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVENTCARE INC

Provider Business Mailing Address
First Line	:	35 AVCO RD
Second Line	:
City	:	HAVERHILL
State	:	MA
Zip	:	01835-6936
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 LAFAYETTE ST
Second Line	:
City	:	MARBLEHEAD
State	:	MA
Zip	:	01945-1939
Country	:	US
Telephone Number	:	781-631-4535
Fax Number	:

Authorized Official
Title or Position	:	CORPORATE BUSINESS MANAGER
Name	:	LAURA R MCDONNELL
Credential	:
Telephone Number	:	978-420-1500

Provider Enumeration Date	:	11/20/2007
Last Update Date	:	11/27/2007

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Directions to “ADVENTCARE INC ” Practice Location

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