NPIMap

Organization Active NPI

Mary Immaculate Adult Day Health II

  • Adult Day Care Clinic/Center
  • Lawrence, MA
National Provider Identifier
1912290081
Registry record updated May 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
MARY IMMACULATE ADULT DAY HEALTH II
Practice address
193 Maple St
Lawrence, MA 01841-3763
Phone
(978) 682-7575
NPI assigned
May 24, 2011
Last updated
May 24, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
MARY IMMACULATE HEALTH/CARE SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 24, 2011

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

Authorized official

Name
Ms. Barbara Grant
Title
President / Ceo
Phone
(978) 685-6321

Specialties & licenses 1

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

Addresses

Primary practice location

193 Maple St
Lawrence, MA 01841-3763

Mailing address

172 Lawrence St
Lawrence, MA 01841-3849

Other identifiers 1

IdentifierTypeStateIssuer
110032662CMedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
Mary Immaculate Adult Day Health Center Inc3 organizations share this tax ID, including this one
Part of
Mary Immaculate Adult Day Health Center Inc

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306195200000",
    "number": "1912290081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 LAWRENCE ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018413849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 MAPLE ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018413763",
            "telephone_number": "978-682-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY IMMACULATE ADULT DAY HEALTH II",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARY IMMACULATE HEALTH/CARE SERVICES",
        "enumeration_date": "2011-05-24",
        "last_updated": "2011-05-24",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "978-685-6321",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110032662C",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; 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.