SUDBURY PINES EXTENDED CARE FACILITY NPI 1811024664

NPI Information

SUDBURY PINES EXTENDED CARE FACILITY is a hospice care community based in Sudbury, MA. SUDBURY PINES EXTENDED CARE FACILITY NPI is 1811024664. The provider is registered as an organization entity type.
The provider Is Doing Business As Sudbury Pines Hospice.

The provider's business location address is:

642 BOSTON POST RD
SUDBURY, MA
ZIP 01776-302
Phone: (617) 512-6625
Fax: (978) 443-9510

The provider's authorized official is Roberta C Henderson .
The authorized official title is Administrator and has the following contact phone number (617) 512-6625.

The CLIA number assigned to this NPI record is 22D0877158 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/28/2007 and was last updated on 2/8/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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