| Organization Name: | REVERE ADULT DAY HEALTH CARE |
| NPI Number: | 1174837033 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VICTORIA VINOKUR (MANAGER) |
| Mailing Address: | 765 Revere Beach Pkwy Revere |
| State: | MA US |
| Postal Code: | 021515318 |
| Phone Number: | 3013704714 |
| Fax Number: | 3015608270 |
| NPI Enumeration Date: | 08/03/2010 |
| NPI Last Update Date: | 08/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |