MEDICARE: MARLBORO HILLS MA SNF 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	314000000X	Skilled Nursing Facility	0376	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245641927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARLBORO HILLS MA SNF LLC

Provider Business Mailing Address
First Line	:	121 NORTHBORO RD E
Second Line	:
City	:	MARLBOROUGH
State	:	MA
Zip	:	01752-1844
Country	:	US
Telephone Number	:	508-485-4040
Fax Number	:	508-481-5585

Provider Business Practice Location Address
First Line	:	121 NORTHBORO RD E
Second Line	:
City	:	MARLBOROUGH
State	:	MA
Zip	:	01752-1844
Country	:	US
Telephone Number	:	508-485-4040
Fax Number	:	508-481-5585

Authorized Official
Title or Position	:	MANAGER
Name	:	LAWRENCE G. SANTILLI
Credential	:
Telephone Number	:	860-751-3900

Provider Enumeration Date	:	05/15/2014
Last Update Date	:	03/02/2023

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