Provider Demographics
NPI:1083442016
Name:APEX ADULT FOSTER CARE LLC
Entity type:Organization
Organization Name:APEX ADULT FOSTER CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MEKONNEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHAGARIE
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:617-304-6600
Mailing Address - Street 1:182 SYLVAN ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-1746
Mailing Address - Country:US
Mailing Address - Phone:617-304-6600
Mailing Address - Fax:
Practice Address - Street 1:182 SYLVAN ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-1746
Practice Address - Country:US
Practice Address - Phone:617-304-6600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency