Healthcare Provider Details

I. General information

NPI: 1093958126
Provider Name (Legal Business Name): PLEASANT BAY HEALTH AND LIVING CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2009
Last Update Date: 04/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 WOODLANDS WAY
BREWSTER MA
02631-5259
US

IV. Provider business mailing address

120 WOODLANDS WAY
BREWSTER MA
02631-5259
US

V. Phone/Fax

Practice location:
  • Phone: 508-240-3500
  • Fax:
Mailing address:
  • Phone: 508-240-3500
  • Fax: 508-240-1969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: ROXANNE M WEBASTER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 508-240-3500