Provider Demographics
NPI:1972714475
Name:EPOCH SENIOR HEALTH CARE OF WESTON
Entity type:Organization
Organization Name:EPOCH SENIOR HEALTH CARE OF WESTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAFTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-891-6100
Mailing Address - Street 1:79 GAINSBOROUGH ST
Mailing Address - Street 2:#204
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6516
Mailing Address - Country:US
Mailing Address - Phone:617-262-4536
Mailing Address - Fax:
Practice Address - Street 1:75 NORUMBEGA RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-2431
Practice Address - Country:US
Practice Address - Phone:781-891-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty