200 Governors Opco LLC
NPI #1053178582 in Medford, Massachusetts
Provider Information
- NPI Number
- 1053178582
- Entity Type
- Organization
- Organization Name
- 200 Governors Opco LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Mar 1, 2024
- Last Updated
- Mar 1, 2024
Practice Location
- Address
- 200 GOVERNORS AVE
- City
- Medford
- State
- Massachusetts
- ZIP Code
- 02155-1644
- Phone
- (781) 391-5400
Authorized Official
- Name
- ELIYAHU MIRLIS
- Title
- OWNER
- Phone
- (732) 961-8491
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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