Healthcare Provider Details

I. General information

NPI: 1487547543
Provider Name (Legal Business Name): OC MILFORD GARDENS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2025
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 VETERANS MEMORIAL DR
MILFORD MA
01757-2900
US

IV. Provider business mailing address

10 VETERANS MEMORIAL DR
MILFORD MA
01757-2900
US

V. Phone/Fax

Practice location:
  • Phone: 508-473-6414
  • Fax:
Mailing address:
  • Phone: 508-473-6414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: AZRIEL LIEBERMAN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 845-500-8619