Provider Demographics
NPI:1427605211
Name:ADVOCATE HEALTHCARE OF EAST BOSTON- ADULT DAY HEALTH CARE
Entity type:Organization
Organization Name:ADVOCATE HEALTHCARE OF EAST BOSTON- ADULT DAY HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-455-6112
Mailing Address - Street 1:111 ORIENT AVE
Mailing Address - Street 2:
Mailing Address - City:EAST BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128-1006
Mailing Address - Country:US
Mailing Address - Phone:617-569-2100
Mailing Address - Fax:
Practice Address - Street 1:111 ORIENT AVE
Practice Address - Street 2:
Practice Address - City:EAST BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-1006
Practice Address - Country:US
Practice Address - Phone:617-569-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVOCATE HEALTHCARE OF EAST BOSTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care