Organization
411 WAVERLY OAKS RD, SUITE#214, WALTHAM, MA 02452
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WOLF GAFANOVICH RN (CLINICAL DIRECTOR)
(617) 513-2158
Entity
Organization
Contact information
Practice address
411 WAVERLY OAKS RD, WALTHAM, MA 02452-8448
(617) 513-2158
(617) 206-3195
Mailing address
411 WAVERLY OAKS RD STE 214, WALTHAM, MA 02452-8437
(617) 513-2158
(617) 206-3195
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
MA
Other
Enumeration date
06/21/2012
Last updated
06/21/2012
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