120 Main Street Operator LLC
NPI #1558890939 in Malden, Massachusetts
Provider Information
- NPI Number
- 1558890939
- Entity Type
- Organization
- Organization Name
- 120 Main Street Operator LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- NEXT STEP HEALTHCARE LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Jun 8, 2017
- Last Updated
- Jun 8, 2017
Practice Location
- Address
- 120 MAIN ST
- City
- Malden
- State
- Massachusetts
- ZIP Code
- 02148-6904
- Phone
- (781) 324-5600
Authorized Official
- Name
- WILLIAM HOWARD STEPHAN
- Title
- CHIEF FINANCIAL OFFICER
- Phone
- (617) 943-7747
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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