Fuente de Vida Adult Day Care Services, LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

FUENTE DE VIDA ADULT DAY CARE SERVICES, LLC

Practice address

130 Bradlee St
Hyde Park, MA 02136-2226

Phone

(617) 921-1041

Fax

(617) 323-8886

NPI assigned

Mar 3, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Vadim Daniel Binder

Title

Program Director

Phone

(617) 921-1041

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236038400000",
    "number": "1265672265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 BRADLEE ST",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021362226",
            "telephone_number": "617-921-1041",
            "fax_number": "617-323-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 BRADLEE ST",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021362226",
            "telephone_number": "617-921-1041",
            "fax_number": "617-323-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUENTE DE VIDA ADULT DAY CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-03",
        "last_updated": "2009-03-03",
        "status": "A",
        "authorized_official_last_name": "BINDER",
        "authorized_official_first_name": "VADIM",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "617-921-1041",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Foley, DMD
• Anntoinette Simone Francis
• Claude Francois
• Jefferson Francois
• Katie Frechette
• Sana Morondia Gabisi, RN
• Gahcr II Hyde Park SNF TRS Sub, LLC
• Gascard Gaston
• Gabriel Gbidye, RN
• Genesis Rehab

• Adult Day Care Clinic/Center in Hyde Park, MA
• Providers in Hyde Park, MA by specialty
• Adult Day Care Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.