1200 Suffield Street Operator LLC
NPI #1437675527 in Agawam, Massachusetts
Provider Information
- NPI Number
- 1437675527
- Entity Type
- Organization
- Organization Name
- 1200 Suffield Street Operator LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Aug 21, 2017
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 1200 SUFFIELD ST
- City
- Agawam
- State
- Massachusetts
- ZIP Code
- 01001-2933
- Phone
- (413) 789-2200
Authorized Official
- Name
- WILLIAM H STEPHAN
- Title
- CFO
- Phone
- (617) 943-7747
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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