Healthcare Provider Details

I. General information

NPI: 1073239752
Provider Name (Legal Business Name): NAVIGATOR HOMES OF MARTHA'S VINEYARD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2022
Last Update Date: 10/14/2022
Certification Date: 10/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL RD
OAK BLUFFS MA
02557-1406
US

IV. Provider business mailing address

PO BOX 1356
VINEYARD HAVEN MA
02568-0905
US

V. Phone/Fax

Practice location:
  • Phone: 508-696-6465
  • Fax:
Mailing address:
  • Phone:
  • 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: MS. MARY R. BROWN
Title or Position: TREASURER
Credential:
Phone: 508-524-3986