| NPI | 1669676433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER B BASKIN Ccc Slp 508-381-1952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MA SLP76) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: MA 76SLP) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2020-08-22 |