Provider Demographics
NPI:1558457408
Name:LAXMI CORPORATION
Entity Type:Organization
Organization Name:LAXMI CORPORATION
Other - Org Name:RESIDENT CARE REHABILITATION AND NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:INDIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:DSC
Authorized Official - Phone:508-879-6420
Mailing Address - Street 1:PO BOX 887
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-0887
Mailing Address - Country:US
Mailing Address - Phone:508-879-6420
Mailing Address - Fax:508-875-8872
Practice Address - Street 1:228 CONCORD ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6713
Practice Address - Country:US
Practice Address - Phone:508-879-6420
Practice Address - Fax:508-875-8872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0368314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0918571Medicaid
MA0918571Medicaid