Healthcare Provider Details

I. General information

NPI: 1972599124
Provider Name (Legal Business Name): WEST BOYLSTON NURSING HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 05/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 N MAIN STREET
WEST BOYLSTON MA
01583-1130
US

IV. Provider business mailing address

54 BOYDEN ROAD
HOLDEN MA
01520-2570
US

V. Phone/Fax

Practice location:
  • Phone: 508-829-1110
  • Fax: 508-829-1235
Mailing address:
  • Phone: 508-829-1110
  • Fax: 508-829-1235

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: MR. DAVID ORIOL
Title or Position: ADMINISTRATOR
Credential:
Phone: 508-829-1110