Organization
COREY ASSISTED LIVING LLC
Active
Other names
Providence House Senior Living Community
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD JOHNSON (EXECUTIVE DIRECTOR)
(617) 731-0505
Entity
Organization
Contact information
Practice address
180 COREY RD, BRIGHTON, MA 02135-8239
(617) 731-0505
(617) 731-0599
Mailing address
180 COREY RD, BRIGHTON, MA 02135-8239
(617) 731-0505
(617) 731-0599
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
03/16/2007
Last updated
08/22/2020
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