Healthcare Provider Details

I. General information

NPI: 1982109518
Provider Name (Legal Business Name): SEKATI RESIDENCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2018
Last Update Date: 03/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 WHITEWOOD RD
MILFORD MA
01757-1300
US

IV. Provider business mailing address

12 WHITEWOOD RD
MILFORD MA
01757-1300
US

V. Phone/Fax

Practice location:
  • Phone: 508-816-4036
  • Fax:
Mailing address:
  • Phone: 508-816-4036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VILLEROY TAH
Title or Position: DIRECTOR
Credential: MSN, BSN, RN.
Phone: 508-816-4036