Active NPI
2ND Home Adhc, LLC Dba Arevik Adhc
- Adult Day Care Clinic/Center
- Watertown, MA
National Provider Identifier
1073753737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Day Care Clinic/Center
- Legal business name
- 2ND HOME ADHC, LLC DBA AREVIK ADHC
- Practice address
- 51 Water St Unit B
Watertown, MA 02472-4611 - Phone
- (617) 924-1212
- Fax
- (617) 924-1228
- NPI assigned
- Feb 20, 2009
- Last updated
- Feb 20, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Inna Proshak
- Title
- Manager
- Phone
- (323) 854-0678
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | Primary |
Addresses
Primary practice location
51 Water St Unit B
Watertown, MA 02472-4611
Mailing address
51 Water St Unit B
Watertown, MA 02472-4611
Phone (617) 924-1212
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1907069 | Other | PROVIDER NUMBER |
National Provider Directory
National Provider DirectoryLocations
51 Water St
Unit B
Watertown, MA 02472
Phone (617) 782-5100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235088000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1235088000000",
"number": "1073753737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 WATER ST UNIT B",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024724611",
"telephone_number": "617-924-1212",
"fax_number": "617-924-1228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 WATER ST UNIT B",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024724611",
"telephone_number": "617-924-1212",
"fax_number": "617-924-1228"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "2ND HOME ADHC, LLC DBA AREVIK ADHC",
"organizational_subpart": "NO",
"enumeration_date": "2009-02-20",
"last_updated": "2009-02-20",
"status": "A",
"authorized_official_last_name": "PROSHAK",
"authorized_official_first_name": "INNA",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "323-854-0678",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER NUMBER",
"identifier": "1907069",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Watertown, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.