Provider Demographics
NPI:1528000676
Name:WHITNEY PLACE AT NATICK LIMITED
Entity Type:Organization
Organization Name:WHITNEY PLACE AT NATICK LIMITED
Other - Org Name:WHITNEY PLACE AT NATICK LIMITED PARTNERSHIP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MCGINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:CNHA, FELLOW ACHCA
Authorized Official - Phone:508-655-3344
Mailing Address - Street 1:3 VISION DR
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-2059
Mailing Address - Country:US
Mailing Address - Phone:508-655-3344
Mailing Address - Fax:508-655-9702
Practice Address - Street 1:3 VISION DR
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-2059
Practice Address - Country:US
Practice Address - Phone:508-655-3344
Practice Address - Fax:508-655-9702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA037H314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0923702Medicaid
MA225727Medicare ID - Type UnspecifiedPROVIDER NUMBER