MEDICARE: FIVE STAR WOODLANDS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	113134	TX
2	310400000X	Assisted Living Facility	100813	TX
3	310400000X	Assisted Living Facility	113136	TX

General Provider Information

NPI Number	:	1184640757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIVE STAR WOODLANDS LLC

Provider Business Mailing Address
First Line	:	400 CENTRE ST
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02458-2094
Country	:	US
Telephone Number	:	617-219-1400
Fax Number	:	617-796-8243

Provider Business Practice Location Address
First Line	:	5055 W PANTHER CREEK DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77381-3500
Country	:	US
Telephone Number	:	281-292-2600
Fax Number	:	281-292-1836

Authorized Official
Title or Position	:	PRESIDENT & CHIEF EXECUTIVE OFFICER
Name	:	KATHERINE E POTTER
Credential	:
Telephone Number	:	617-796-8387

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	12/11/2023

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Directions to “FIVE STAR WOODLANDS LLC ” Practice Location

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