MEDICARE: ALBA ADULT FOSTER CARE LLC

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	253Z00000X	In Home Supportive Care Agency
2	253J00000X	Foster Care Agency

General Provider Information

NPI Number	:	1770386328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALBA ADULT FOSTER CARE LLC

Provider Business Mailing Address
First Line	:	88 PLEASANT ST APT 102
Second Line	:
City	:	WEYMOUTH
State	:	MA
Zip	:	02190-2451
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	88 PLEASANT ST APT 102
Second Line	:
City	:	WEYMOUTH
State	:	MA
Zip	:	02190-2451
Country	:	US
Telephone Number	:	781-635-2269
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	NICOLE JANKOWSKI
Credential	:
Telephone Number	:	781-635-2269

Provider Enumeration Date	:	03/29/2025
Last Update Date	:	04/10/2025

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