Basic Information
| Provider Information | |||||||||
| NPI: | 1770628729 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAPEWAY ADULT DAY HEALTH CENTER, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 81 WELBY RD | ||||||||
| Address2: | |||||||||
| City: | NEW BEDFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027451118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089859076 | ||||||||
| FaxNumber: | 5089859026 | ||||||||
| Practice Location | |||||||||
| Address1: | 81 WELBY RD | ||||||||
| Address2: | |||||||||
| City: | NEW BEDFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027451118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089859076 | ||||||||
| FaxNumber: | 5089859026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | COSME | ||||||||
| AuthorizedOfficialFirstName: | JAKE | ||||||||
| AuthorizedOfficialMiddleName: | A. | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5089859076 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA0600X | Y | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care |
ID Information
| ID | Type | State | Issuer | Description | 1902938 | 05 | MA | MEDICAID |