411 WAVERLY OAKS RD SUITE#214 WALTHAM MA 02452 NPI 1902169105

NPI Information

411 WAVERLY OAKS RD, SUITE#214, WALTHAM, MA 02452 is an adult day care clinic center in Waltham, MA. 411 WAVERLY OAKS RD, SUITE#214, WALTHAM, MA 02452 NPI is 1902169105. The provider is registered as an organization entity type.

The provider's business location address is:

411 WAVERLY OAKS RD
WALTHAM, MA
ZIP 02452-448
Phone: (617) 513-2158
Fax: (617) 206-3195

The provider's authorized official is Wolf Gafanovich .
The authorized official title is Clinical Director and has the following contact phone number (617) 513-2158.

The enumeration date for this NPI number is 6/21/2012 and was last updated on 6/21/2012.

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:

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