Provider Demographics
NPI:1609225721
Name:ROYAL WAYLAND NURSING HOME LLC
Entity Type:Organization
Organization Name:ROYAL WAYLAND NURSING HOME LLC
Other - Org Name:ROYAL AT WAYLAND REHABILITATION & NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-763-2700
Mailing Address - Street 1:42 WINTER ST STE 1
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-4958
Mailing Address - Country:US
Mailing Address - Phone:781-826-2393
Mailing Address - Fax:
Practice Address - Street 1:188 COMMONWEALTH RD
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MA
Practice Address - Zip Code:01778-5027
Practice Address - Country:US
Practice Address - Phone:508-653-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-09
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility