NPI 1194254565 · live from the CMS NPI Registry
743 Main Street Operator LLC
Skilled Nursing Facility in Melrose, MA. National Provider Identifier 1194254565, active.
NPI record
| NPI | 1194254565 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 743 Main St, Melrose, MA 02176 |
| Practice phone | 781-662-7500 |
| Mailing address | 75 2nd Ave Ste 605, Needham, MA 02494 |
| Enumerated | June 8, 2017 |
| Last updated | June 8, 2017 |
| Authorized official | William Stephan, Chief Financial Officer |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.