| NPI | 1508852757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA MAHONEY Administrator 508-829-1104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: MA 0930172) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2013-04-17 |