MEDICARE: SUNNY ACRES OPCO 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
2	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1306624325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNNY ACRES OPCO LLC

Provider Business Mailing Address
First Line	:	15 RICHARDS RD # 16
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-4871
Country	:	US
Telephone Number	:	508-927-2754
Fax Number	:

Provider Business Practice Location Address
First Line	:	254 BILLERICA RD
Second Line	:
City	:	CHELMSFORD
State	:	MA
Zip	:	01824-4114
Country	:	US
Telephone Number	:	978-256-1616
Fax Number	:

Authorized Official
Title or Position	:	OFFICER
Name	:	PATRICK FLAHERTY
Credential	:
Telephone Number	:	508-927-2754

Provider Enumeration Date	:	09/20/2023
Last Update Date	:	10/06/2023

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Directions to “SUNNY ACRES OPCO LLC ” Practice Location

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