Basic Information
| Provider Information | |||||||||
| NPI: | 1871135970 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PLEASANT BAY OF BREWSTER ASSISTED LIVING LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 320 NORWOOD PARK SOUTH | ||||||||
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| City: | NORWOOD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7812550531 | ||||||||
| FaxNumber: | 7817621502 | ||||||||
| Practice Location | |||||||||
| Address1: | 120 WOODLANDS WAY | ||||||||
| Address2: | |||||||||
| City: | BREWSTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5082401990 | ||||||||
| FaxNumber: | 5082401175 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2019 | ||||||||
| LastUpdateDate: | 10/10/2019 | ||||||||
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| AuthorizedOfficialLastName: | LABELLA | ||||||||
| AuthorizedOfficialFirstName: | CATERINA | ||||||||
| AuthorizedOfficialMiddleName: | MINA | ||||||||
| AuthorizedOfficialTitleorPosition: | CONTROLLER | ||||||||
| AuthorizedOfficialTelephone: | 7812550531 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.