Provider Demographics
NPI:1386634822
Name:JHC ASSISTED LIVING CORP.
Entity type:Organization
Organization Name:JHC ASSISTED LIVING CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:A
Authorized Official - Last Name:LIBRANDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-757-0981
Mailing Address - Street 1:631 SALISBURY ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-1120
Mailing Address - Country:US
Mailing Address - Phone:508-757-0981
Mailing Address - Fax:508-757-7080
Practice Address - Street 1:631 SALISBURY ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-1120
Practice Address - Country:US
Practice Address - Phone:508-757-0981
Practice Address - Fax:508-757-7080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1904523Medicaid