Organization
2ND HOME ADHC, LLC DBA AREVIK ADHC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. INNA PROSHAK (MANAGER)
(323) 854-0678
Entity
Organization
Contact information
Practice address
51 WATER ST UNIT B, WATERTOWN, MA 02472-4611
(617) 924-1212
(617) 924-1228
Mailing address
51 WATER ST UNIT B, WATERTOWN, MA 02472-4611
(617) 924-1212
(617) 924-1228
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1907069
PROVIDER NUMBER
—
Enumeration date
02/20/2009
Last updated
02/20/2009
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