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NPI Code Detail

MEDICARE: WINGATE AT NEEDHAM, INC.

MEDICARE: WINGATE AT NEEDHAM, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility0RW6MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033168984
Entity Type Code : Organization
Provider Name (Legal Business Name) : WINGATE AT NEEDHAM, INC.
Provider Business Mailing Address
First Line : 63 KENDRICK ST
Second Line :
City : NEEDHAM
State : MA
Zip : 02494-2708
Country : US
Telephone Number : 781-707-9085
Fax Number : 781-707-9285
Provider Business Practice Location Address
First Line : 589 HIGHLAND AVE
Second Line :
City : NEEDHAM
State : MA
Zip : 02494-2205
Country : US
Telephone Number : 781-455-9090
Fax Number : 781-455-9012
Authorized Official
Title or Position : CFO
Name : MS. TAMILYN M. LEVIN
Credential : ESQ.
Telephone Number : 781-707-9510
Provider Enumeration Date : 05/09/2006
Last Update Date : 10/05/2012

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