| NPI | 1770905002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNEDY LEE Administrator 781-961-3320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 311Z00000X Custodial Care Facility |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2024-05-15 |