Organization Active NPI

2ND Home Adhc, LLC Dba Arevik Adhc

  • Adult Day Care Clinic/Center
  • Watertown, MA
National Provider Identifier
1073753737
Registry record updated Feb 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
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, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2009

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1907069OtherPROVIDER NUMBER

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.