620 Laurel Street Operator LLC
NPI #1902322001 in Lee, Massachusetts
Provider Information
- NPI Number
- 1902322001
- Entity Type
- Organization
- Organization Name
- 620 Laurel Street Operator LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Aug 21, 2017
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 620 LAUREL ST
- City
- Lee
- State
- Massachusetts
- ZIP Code
- 01238-9181
- Phone
- (413) 243-2010
Authorized Official
- Name
- WILLIAM H STEPHAN
- Title
- CFO
- Phone
- (617) 943-7747
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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