Organization Active NPI

Vitra Adult Day Health I, LLC

  • Adult Day Care Clinic/Center
  • Brockton, MA
National Provider Identifier
1639718596
Registry record updated Dec 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
VITRA ADULT DAY HEALTH I, LLC
Practice address
10 N Pearl St
Brockton, MA 02301-1708
Phone
(508) 594-8708
NPI assigned
Dec 24, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2019

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

Authorized official

Name
Edward Spivak
Title
Manager
Phone
(508) 594-8288

Specialties & licenses 1

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

Addresses

Primary practice location

10 N Pearl St
Brockton, MA 02301-1708

Mailing address

10 N Pearl St
Brockton, MA 02301-1708
Phone (508) 594-8708

Other names 1

  • Vitra Adult Day Health 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
22D2176215Vitra Adult Day Health10 N Pearl Street, Brockton, MA 02301Certificate of waiverOct 21, 2026

National Provider Directory

National Provider Directory

Locations

10 N Pearl St
Brockton, MA 02301
Phone (508) 584-6300

NPI Registry JSON

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

{
    "created_epoch": "1577145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577145600000",
    "number": "1639718596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 N PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011708",
            "telephone_number": "508-594-8708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011708",
            "telephone_number": "508-594-8708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITRA ADULT DAY HEALTH I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-24",
        "last_updated": "2019-12-24",
        "certification_date": "2019-12-24",
        "status": "A",
        "authorized_official_last_name": "SPIVAK",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "508-594-8288"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vitra Adult Day Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2019; 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.