Healthcare Provider Details

I. General information

NPI: 1912992918
Provider Name (Legal Business Name): GERIATRIC FACILITIES OF CAPE COD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 12/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

383 S ORLEANS RD
BREWSTER MA
02631-2870
US

IV. Provider business mailing address

383 S ORLEANS RD
BREWSTER MA
02631-2870
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0984
License Number StateMA

VIII. Authorized Official

Name: MR. JOSHUA L. ZUCKERMAN
Title or Position: PRESIDENT/ADMINISTRATOR
Credential:
Phone: 508-240-3500