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General NPI Number Information
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NPI Number | 1871135970
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Entity Type | Organization
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Legal Business Name | PLEASANT BAY OF BREWSTER ASSISTED LIVING LLC
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Dates
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Enumeration Date | 10/10/2019
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Last Update Date | 10/10/2019
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Provider Practice Location Address
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Address Line | 120 WOODLANDS WAY
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City | BREWSTER
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State | MA
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Zip | 02631
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Country | US
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Telephone | 508-240-1990
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Fax | 508-240-1175
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Provider Business Mailing Address
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Address Line | 320 NORWOOD PARK SOUTH
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City | NORWOOD
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State | MA
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Zip | 02062
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Country | US
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Telephone | 781-255-0531
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Fax | 781-762-1502
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Authorized Official
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Title or Position | CONTROLLER
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Name | CATERINA MINA LABELLA
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Credential |
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Telephone | 781-255-0531
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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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