Organization
CITY OF PEABODY
Active
Other names
Roger B. Trask Adult Day Health
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTIN CROCKETT M.S.G. (PROGRAM COORDINATOR)
(978) 531-2254
Entity
Organization
Contact information
Practice address
79 CENTRAL ST, PEABODY, MA 01960-4353
(978) 531-2254
(978) 531-7176
Mailing address
79 CENTRAL ST, PEABODY, MA 01960-4353
(978) 531-2254
(978) 531-7176
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902121
—
MA
Enumeration date
02/06/2007
Last updated
08/22/2020
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