NPIMap

Organization Active NPI

Adult Day Health, Inc.

Doing business as Renaissance Adult Day Health Center

  • Adult Day Care Clinic/Center
  • Worcester, MA
National Provider Identifier
1639544919
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
ADULT DAY HEALTH, INC.
Doing business as
Renaissance Adult Day Health Center
Practice address
1040 Southbridge St
Worcester, MA 01610-2235
Phone
(508) 925-0389
NPI assigned
Dec 11, 2015
Last updated
Sep 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Authorized official

Name
Susan R Redd-Garcelon, RN
Title
VP Qi
Phone
(508) 733-2552

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X Primary

Addresses

Primary practice location

1040 Southbridge St
Worcester, MA 01610-2235

Mailing address

225 Foxborough Blvd Ste 103
Foxborough, MA 02035-3062
Phone (508) 733-2552

Other identifiers 1

IdentifierTypeStateIssuer
110100665JMedicaidMA

Other names 1

  • Renaissance Adult Day Health Center Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D2109745Renaissance Adult Day Health Center1040 Southbridge St, Worcester, MA 01610Certificate of waiverFeb 29, 2028

National Provider Directory

National Provider Directory
Tax ID family
Adult Day Health Inc49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

Organizations that report the same tax identification number in the National Provider Directory.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1639544919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 FOXBOROUGH BLVD STE 103",
            "city": "FOXBOROUGH",
            "state": "MA",
            "postal_code": "020353062",
            "telephone_number": "508-733-2552",
            "fax_number": "774-215-5708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 SOUTHBRIDGE ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102235",
            "telephone_number": "508-925-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT DAY HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-11",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A",
        "authorized_official_last_name": "REDD-GARCELON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VP QI",
        "authorized_official_telephone_number": "508-733-2552",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110100665J",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renaissance Adult Day Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Renaissance Adult Day Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.