Organization
KRE HUSKY PLYMOUTH LICENSEE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS H. GRAPE (PRESIDENT)
(781) 489-7100
Entity
Organization
Contact information
Practice address
157 SOUTH ST, PLYMOUTH, MA 02360-7605
(508) 297-6518
Mailing address
201 JONES RD STE 300, WALTHAM, MA 02451-1618
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
06/04/2019
Last updated
06/04/2019
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