RENAISSANCE ADULT DAY CARE LLC NPI 1851681324

NPI Information

NPI: 1851681324
Provider Name: RENAISSANCE ADULT DAY CARE, LLC
Classification: Clinic/Center - 261QA0600X
Entity Type: Organization

Specialization: Adult Day Care

CLIA Number: 22D2109745

Address:
1040 SOUTHBRIDGE STREET
WORCESTER, MA
ZIP 01610
Phone: (508) 925-0389
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RENAISSANCE ADULT DAY CARE, LLC is an adult day care clinic center in Worcester, MA. RENAISSANCE ADULT DAY CARE, LLC NPI is 1851681324. The provider is registered as an organization entity type.

The provider's business location address is:

1040 SOUTHBRIDGE STREET
WORCESTER, MA
ZIP 01610
Phone: (508) 925-0389
Fax: (508) 258-9767

The provider's authorized official is Dmitry Burshteyn .
The authorized official title is Member and has the following contact phone number (508) 925-0389.

The CLIA number assigned to this NPI record is 22D2109745 - other - adult day health program with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/18/2011 and was last updated on 1/12/2015.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA0600X	Clinic/Center	Adult Day Care			Yes

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: 5/5/2024

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