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STAY WELL AHDC INC. NPI 1679615330


NPI Information

NPI: 1679615330
Provider Name: STAY WELL AHDC, INC.
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

CLIA Number: 22D2109736

Address:
45 CONGRESS ST
SALEM, MA
ZIP 01970
Phone: (978) 825-0202
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STAY WELL AHDC, INC. is an adult care home custodial care facility in Salem, MA. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. STAY WELL AHDC, INC. NPI is 1679615330. The provider is registered as an organization entity type.

The provider's business location address is:

45 CONGRESS ST
SALEM, MA
ZIP 01970-579
Phone: (978) 825-0202

The provider's authorized official is Stella Kremenchugsky .
The authorized official title is Program Director and has the following contact phone number (781) 718-8472.

The CLIA number assigned to this NPI record is 22D2109736 - other - adult health day care with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/12/2007 and was last updated on 7/11/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311ZA0620XCustodial Care FacilityAdult Care Home1904591MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11904591MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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