| NPI | 1699762898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES DILLON Administrator 978-682-1614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MA 0802) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: MA 871) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2015-09-14 |