Healthcare Provider Details

I. General information

NPI: 1821084591
Provider Name (Legal Business Name): HASKELL LTD PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 PARKER HILL AVE
ROXBURY CROSSING MA
02120-3218
US

IV. Provider business mailing address

63 PARKER HILL AVE
ROXBURY CROSSING MA
02120-3218
US

V. Phone/Fax

Practice location:
  • Phone: 617-975-0110
  • Fax: 917-975-0140
Mailing address:
  • Phone: 617-975-0110
  • Fax: 917-975-0140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateMA

VIII. Authorized Official

Name: SHERYL DORNFELD
Title or Position: EXECUTIVE DIRECTOR
Credential: RN
Phone: 617-975-0110