Healthcare Provider Details

I. General information

NPI: 1629258306
Provider Name (Legal Business Name): EPOCH OF BREWSTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2007
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

873 HARWICH RD
BREWSTER MA
02631-5232
US

IV. Provider business mailing address

51 SAWYER RD STE 500
WALTHAM MA
02453-3461
US

V. Phone/Fax

Practice location:
  • Phone: 508-896-7046
  • Fax:
Mailing address:
  • Phone: 781-810-1240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0837
License Number StateMA

VIII. Authorized Official

Name: DEBORA PFAFF
Title or Position: CFO
Credential:
Phone: 781-810-1240