Provider Demographics
NPI:1740872423
Name:WSL EAST SIDE OP, LLC
Entity type:Organization
Organization Name:WSL EAST SIDE OP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARALEGAL
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-707-9085
Mailing Address - Street 1:63 KENDRICK ST
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-2760
Mailing Address - Country:US
Mailing Address - Phone:781-707-9000
Mailing Address - Fax:
Practice Address - Street 1:1 BUTLER AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5119
Practice Address - Country:US
Practice Address - Phone:401-275-0682
Practice Address - Fax:401-275-0691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility