Provider Demographics
NPI:1093958126
Name:PLEASANT BAY HEALTH AND LIVING CENTERS, LLC
Entity Type:Organization
Organization Name:PLEASANT BAY HEALTH AND LIVING CENTERS, LLC
Other - Org Name:THE WOODLANDS AT PLEASANT BAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEBASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-240-3500
Mailing Address - Street 1:120 WOODLANDS WAY
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:MA
Mailing Address - Zip Code:02631-5259
Mailing Address - Country:US
Mailing Address - Phone:508-240-3500
Mailing Address - Fax:508-240-1969
Practice Address - Street 1:120 WOODLANDS WAY
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:MA
Practice Address - Zip Code:02631-5259
Practice Address - Country:US
Practice Address - Phone:508-240-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility