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General NPI Number Information
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NPI Number | 1306293642
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Entity Type | Organization
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Legal Business Name | BANE HANCOCK PARK, LLC
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Dates
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Enumeration Date | 05/17/2016
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 164 PARKINGWAY
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City | QUINCY
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State | MA
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Zip | 02169-5020
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Country | US
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Telephone | 617-773-4222
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Fax | 617-773-1115
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Provider Business Mailing Address
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Address Line | 350 GRANITE ST STE 2304
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City | BRAINTREE
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State | MA
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Zip | 02184-4963
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Country | US
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Telephone | 781-474-2263
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF REVENUE CYCLE MANAGEMEN
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Name | PAMELA PENNELL
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Credential |
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Telephone | 603-923-9437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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