Provider Demographics
NPI:1326489261
Name:SHI - II HANSON, LLC
Entity Type:Organization
Organization Name:SHI - II HANSON, LLC
Other - Org Name:ALL AMERICAN ASSISTED LIVING AT HANSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:DIOGUARDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-496-1505
Mailing Address - Street 1:1074 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HANSON
Mailing Address - State:MA
Mailing Address - Zip Code:02341
Mailing Address - Country:US
Mailing Address - Phone:781-447-4100
Mailing Address - Fax:
Practice Address - Street 1:1074 WEST WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HANSON
Practice Address - State:MA
Practice Address - Zip Code:02341
Practice Address - Country:US
Practice Address - Phone:781-447-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility