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? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility |