Healthcare Provider Details

I. General information

NPI: 1366752727
Provider Name (Legal Business Name): FIVE STAR QUALITY CARE-MS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2010
Last Update Date: 10/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1488 BELK BLVD.
OXFORD MS
38655
US

IV. Provider business mailing address

400 CENTRE STREET
NEWTON MA
02458
US

V. Phone/Fax

Practice location:
  • Phone: 662-234-8244
  • Fax:
Mailing address:
  • Phone: 617-796-8160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: PAUL HOAGLAND
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 617-796-8387