Provider Demographics
NPI:1851507347
Name:HANCOCK PARK LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:HANCOCK PARK LIMITED PARTNERSHIP
Other - Org Name:HANCOCK PARK ASSISTED LIVING
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:T
Authorized Official - Last Name:CASALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-898-6700
Mailing Address - Street 1:164 PARKINGWAY
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169
Mailing Address - Country:US
Mailing Address - Phone:781-878-6700
Mailing Address - Fax:617-801-0103
Practice Address - Street 1:164 PARKINGWAY
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169
Practice Address - Country:US
Practice Address - Phone:617-471-2600
Practice Address - Fax:617-801-0103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1905147Medicaid