2ND Home Adult Day Health Care II, LLC
Organization Active NPI Adult Day Care Clinic/Center · Watertown, MA
NPI 1437294709 · NPPES record last updated Jun 13, 2008
Key facts
- NPI
- 1437294709
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Day Care Clinic/Center 261QA0600X
- License
- 1900277 (MA)
- Legal business name
- 2ND HOME ADULT DAY HEALTH CARE II, LLC
- Practice address
- 51 Water St
Watertown, MA 02472-4603 - Phone
- (617) 924-1212
- Fax
- (617) 924-1228
- NPI assigned
- Feb 21, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Andrew Feldman
- Title
- Ceo
- Phone
- (617) 584-0258
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 22D2093733 | 2ND Home Adult Day Health Care | Certificate of waiver | Apr 2, 2027 |
| 22D2096086 | Arevik Adult Day Health Care | Certificate of waiver | May 14, 2027 |
National Provider Directory
Locations
51 Water St
Watertown, MA 02472
Phone (617) 331-8338
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | 1900277 | MA | Yes |
Addresses
Primary practice location
51 Water St
Watertown, MA 02472-4603
Mailing address
51 Water St
Watertown, MA 02472-4603
Phone (617) 924-1212
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1900277 | Medicaid | MA |
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.