Provider Demographics
NPI:1437322815
Name:EPOCH OF BREWSTER, LLC
Entity Type:Organization
Organization Name:EPOCH OF BREWSTER, LLC
Other - Org Name:EPOCH ASSISTED LIVING OF BREWSTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:
Authorized Official - Last Name:PFAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-376-2475
Mailing Address - Street 1:51 SAWYER RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-3448
Mailing Address - Country:US
Mailing Address - Phone:877-376-2475
Mailing Address - Fax:
Practice Address - Street 1:855 HARWICH RD
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:MA
Practice Address - Zip Code:02631-5223
Practice Address - Country:US
Practice Address - Phone:508-896-3252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1906836Medicaid