Provider Demographics
NPI:1871135970
Name:PLEASANT BAY OF BREWSTER ASSISTED LIVING LLC
Entity type:Organization
Organization Name:PLEASANT BAY OF BREWSTER ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:CATERINA
Authorized Official - Middle Name:MINA
Authorized Official - Last Name:LABELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-255-0531
Mailing Address - Street 1:320 NORWOOD PARK SOUTH
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062
Mailing Address - Country:US
Mailing Address - Phone:781-255-0531
Mailing Address - Fax:781-762-1502
Practice Address - Street 1:120 WOODLANDS WAY
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:MA
Practice Address - Zip Code:02631
Practice Address - Country:US
Practice Address - Phone:508-240-1990
Practice Address - Fax:508-240-1175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility