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General NPI Number Information
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NPI Number | 1831640283
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Entity Type | Organization
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Legal Business Name | FITCHBURG GARDENS FOR NURSING AND REHABILITATION LLC
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Dates
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Enumeration Date | 10/20/2016
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Last Update Date | 10/20/2016
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Provider Practice Location Address
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Address Line | 94 SUMMER ST
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City | FITCHBURG
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State | MA
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Zip | 01420-5761
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Country | US
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Telephone | 516-505-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 99 W HAWTHORNE AVE
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City | VALLEY STREAM
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State | NY
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Zip | 11580-6163
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Country | US
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Telephone | 516-505-0000
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT OF FINANCE
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Name | MR. ARI STAWIS
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Credential |
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Telephone | 516-505-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0085
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License Number State | MA
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