Provider Demographics
NPI:1760506588
Name:MPI RESIDENT SERVICES, INC.
Entity Type:Organization
Organization Name:MPI RESIDENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:STOCKARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-943-0200
Mailing Address - Street 1:27 MICA LANE SUITE 301
Mailing Address - Street 2:MALONEY PROPERTIES INC
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481
Mailing Address - Country:US
Mailing Address - Phone:781-943-0200
Mailing Address - Fax:781-237-5078
Practice Address - Street 1:27 MICA LANE SUITE 301
Practice Address - Street 2:MALONEY PROPERTIES INC
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481
Practice Address - Country:US
Practice Address - Phone:781-943-0200
Practice Address - Fax:781-237-5078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1904337OtherPROVIDER NUMBER