NPI 1295264679 · live from the CMS NPI Registry
19 Obery Street Operator LLC
Skilled Nursing Facility in Plymouth, MA. National Provider Identifier 1295264679, active.
NPI record
| NPI | 1295264679 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 19 Obery St, Plymouth, MA 02360 |
| Practice phone | 508-747-4790 |
| 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.