| NPI | 1265174825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLEG AGRANOVICH Manager 617-510-0282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2025-09-15 |