Organization
AG ADULT FOSTER CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE GONZALEZ (PRESIDENT)
(407) 319-1233
Entity
Organization
Contact information
Practice address
30 EASTERN AVE. STE 300, MALDEN, MA 02148
(781) 605-3724
(781) 605-3765
Mailing address
30 EASTERN AVE. STE 300, MALDEN, MA 02148
(781) 605-3724
(781) 605-3765
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
03/31/2015
Last updated
10/07/2024
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