Organization
MARIAN MANOR
Active
Other names
Bethany House
Organization subpart
No
Provider details
NPI number
Authorized official
EDMUND J FITZGERALD (EXECUTIVE DIRECTOR)
(508) 679-8154
Entity
Organization
Contact information
Practice address
72 CHURCH GRN, TAUNTON, MA 02780-3445
(508) 822-9200
Mailing address
72 CHURCH GRN, TAUNTON, MA 02780-3445
(508) 822-9200
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902369
—
MA
Enumeration date
06/14/2006
Last updated
08/22/2020
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