Stay Well Ahdc, Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

1904591 Issued in MA

Legal business name

STAY WELL AHDC, INC.

Practice address

45 Congress St
Salem, MA 01970-5579

Phone

(978) 825-0202

NPI assigned

Feb 12, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Stella Kremenchugsky

Title

Program Director

Phone

(781) 718-8472

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1679615330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 CONGRESS ST",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019705579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 CONGRESS ST",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019705579",
            "telephone_number": "978-825-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAY WELL AHDC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "KREMENCHUGSKY",
        "authorized_official_first_name": "STELLA",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "781-718-8472",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MA",
            "license": "1904591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1904591",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Galligan Stacy, MSW LICSW
• Elizabeth Stahl
• Anne Marie Stanton
• Elisabeth Pauline Staten, RN
• Eva M Statz, M.D.
• Matthew Arre Stella, LICSW
• David Stember, PH.D.
• Deborah Frances Stephanides
• Stephanie M. Fitzgerald
• Rory Stern, PSYD

• Adult Care Home Facility in Salem, MA
• Providers in Salem, MA by specialty
• Adult Care Home Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.