Provider Demographics
NPI:1689983793
Name:FVE MW LLC
Entity Type:Organization
Organization Name:FVE MW LLC
Other - Org Name:HUNTINGTON PLACE SENIOR LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-796-8387
Mailing Address - Street 1:400 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-2094
Mailing Address - Country:US
Mailing Address - Phone:617-796-8160
Mailing Address - Fax:
Practice Address - Street 1:3801 NORTH WRIGHT ROAD
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546
Practice Address - Country:US
Practice Address - Phone:608-868-5035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FVE MW LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-07
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility