Lighthouse of Revere, Inc.
NPI #1699772376 in Revere, Massachusetts
Provider Information
- NPI Number
- 1699772376
- Entity Type
- Organization
- Organization Name
- Lighthouse of Revere, Inc.
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Jul 7, 2005
- Last Updated
- Jul 24, 2008
Practice Location
- Address
- 204 PROCTOR AVE
- City
- Revere
- State
- Massachusetts
- ZIP Code
- 02151-4923
- Phone
- (781) 286-3100
Authorized Official
- Name
- MR. ROGER E MARKS
- Title
- ADMINISTRATOR
- Phone
- (781) 286-3100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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