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General NPI Number Information
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NPI Number | 1629967856
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Entity Type | Organization
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Legal Business Name | KRE HUSKY BEDFORD LICENSEE LLC
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 5 CORPORATE DR
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City | BEDFORD
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State | NH
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Zip | 03110-5954
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Country | US
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Telephone | 603-945-1637
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Fax |
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Provider Business Mailing Address
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Address Line | 5 CORPORATE DR
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City | BEDFORD
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State | NH
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Zip | 03110-5954
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS H. GRAPE
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Credential |
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Telephone | 781-489-7100
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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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