Organization
BAYVIEW OF BOSTON ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TADD CLELLAND (EXECUTIVE DIRECTOR)
(617) 268-5450
Entity
Organization
Contact information
Practice address
1380 COLUMBIA RD, SOUTH BOSTON, MA 02127-2934
(617) 268-5450
Mailing address
1380 COLUMBIA RD, SOUTH BOSTON, MA 02127-2934
(617) 268-5450
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
1902075
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902075
—
MA
Enumeration date
03/22/2007
Last updated
06/17/2008
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