1114308210 NPI number — MILFORD ASSISTED LIVING LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114308210 NPI number — MILFORD ASSISTED LIVING LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MILFORD ASSISTED LIVING LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114308210
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
51 SUMMER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROWLEY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01969-1835
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-948-7383
Provider Business Mailing Address Fax Number:
978-948-3421

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 RAILROAD STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01757-4245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-473-4666
Provider Business Practice Location Address Fax Number:
508-902-2015
Provider Enumeration Date:
06/15/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ROMANO
Authorized Official First Name:
FRANK
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
978-948-7383

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)