Organization
FIVE STAR NORTHSHORE LLC
Active
Parent organization
FIVE STAR NORTHSHORE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FIVE STAR NORTHSHORE LLC
Authorized official
BRUCE J. MACKEY JR. (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(617) 796-8214
Entity
Organization
Contact information
Practice address
10803 N PORT WASHINGTON RD, MEQUON, WI 53092-5085
(262) 478-2200
Mailing address
400 CENTRE ST, NEWTON, MA 02458-2094
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
0013000
WI
Other
Enumeration date
04/01/2009
Last updated
05/13/2016
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