Healthcare Provider Details

I. General information

NPI: 1295982841
Provider Name (Legal Business Name): SUNRISE OF LEOMINSTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2008
Last Update Date: 08/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 BETH AVE
LEOMINSTER MA
01453-4900
US

IV. Provider business mailing address

6 BETH AVE
LEOMINSTER MA
01453-4900
US

V. Phone/Fax

Practice location:
  • Phone: 978-537-7600
  • Fax: 978-537-2830
Mailing address:
  • Phone: 978-537-7600
  • Fax: 978-537-2830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. PETER J MACDONALD
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 978-537-7600