Healthcare Provider Details

I. General information

NPI: 1366681587
Provider Name (Legal Business Name): FIVE STAR QUALITY CARE-NS OPERATOR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2009
Last Update Date: 06/23/2020
Certification Date: 06/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 N VALLEY FORGE RD
DEVON PA
19333-1239
US

IV. Provider business mailing address

400 CENTRE ST
NEWTON MA
02458-2094
US

V. Phone/Fax

Practice location:
  • Phone: 610-263-2300
  • Fax:
Mailing address:
  • Phone: 617-796-8387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KATHERINE E POTTER
Title or Position: PRESIDENT & CHIEF EXECUTIVE OFFICER
Credential:
Phone: 617-796-8387