Organization
HAITIAN ADULT DAYCARE, LLC
Active
Organization
HAITIAN ADULT DAYCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IGOR SHREYER (MEMBER)
(857) 222-9940
Entity
Organization
Contact information
Practice address
6 FRONTENAC ST, DORCHESTER CENTER, MA 02124-3902
(617) 288-4155
(617) 288-4177
Mailing address
6 FRONTENAC ST, DORCHESTER CENTER, MA 02124-3902
(617) 288-4155
(617) 288-4177
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
1907034
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1907034
—
MA
Enumeration date
11/24/2008
Last updated
01/13/2009
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