411 Waverly Oaks Rd, Suite#214, Waltham, Ma 02452
NPI #1902169105 in Waltham, Massachusetts
Provider Information
- NPI Number
- 1902169105
- Entity Type
- Organization
- Organization Name
- 411 Waverly Oaks Rd, Suite#214, Waltham, Ma 02452
- Primary Specialty
- Clinic/Center - Adult Day Care
- Enumeration Date
- Jun 21, 2012
- Last Updated
- Jun 21, 2012
Practice Location
- Address
- 411 WAVERLY OAKS RD
- City
- Waltham
- State
- Massachusetts
- ZIP Code
- 02452-8448
- Phone
- (617) 513-2158
Authorized Official
- Name
- MR. WOLF GAFANOVICH, RN
- Title
- CLINICAL DIRECTOR
- Phone
- (617) 513-2158
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Adult Day Care — Adult Day Care |
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