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COMMONWEALTH OF MASSACHUSETTS-DMR

Intermediate Care Facility, Mentally Retarded

Wrentham, Massachusetts

Provider NPI: 1134251366

Organization Information:
Organization Name:  COMMONWEALTH OF MASSACHUSETTS-DMR


Practice Location:
131 EMERALD STREET  WRENTHAM, MA 02093 US
Tel: 508-384-3114  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
MAEXEMPT

Other Provider Identifiers:

IssuerNumberStateType
0916315MA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS MA - Page 1



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