100a West Street Operator LLC
NPI #1770009888 in Needham, Massachusetts
Provider Information
- NPI Number
- 1770009888
- Entity Type
- Organization
- Organization Name
- 100a West Street Operator LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Aug 21, 2017
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 110 WEST ST
- City
- Needham
- State
- Massachusetts
- ZIP Code
- 02494-1399
- Phone
- (781) 444-6655
Authorized Official
- Name
- WILLIAM H STEPHAN
- Title
- CFO
- Phone
- (617) 943-7747
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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