Provider Demographics
NPI:1942236575
Name:EPOCH SL I INC
Entity Type:Organization
Organization Name:EPOCH SL I INC
Other - Org Name:EPOCH SENIOR HEALTHCARE ON BLACKSTONE BLVD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PFAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-891-0777
Mailing Address - Street 1:51 SAWYER ROAD
Mailing Address - Street 2:STE 500 EPOCH SENIOR LIVING INC
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453
Mailing Address - Country:US
Mailing Address - Phone:781-891-0777
Mailing Address - Fax:781-647-0697
Practice Address - Street 1:353 BLACKSTONE BLVD
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906
Practice Address - Country:US
Practice Address - Phone:401-273-6565
Practice Address - Fax:401-273-6568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI415126Medicare Oscar/Certification