Organization
FIVE STAR FOULK MANOR NORTH LLC
Active
Parent organization
FIVE STAR FOULK MANOR NORTH LLC
Other names
Foulk Manor North
Organization subpart
Yes
Provider details
NPI number
Legal business name
FIVE STAR FOULK MANOR NORTH LLC
Authorized official
KATHERINE E POTTER (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(617) 796-8387
Entity
Organization
Contact information
Practice address
1212 FOULK RD, WILMINGTON, DE 19803-2741
(302) 478-4296
(302) 655-5451
Mailing address
400 CENTRE ST, NEWTON, MA 02458-2094
(617) 796-8387
(617) 796-8375
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
1306
DE
314000000X
Skilled Nursing Facility
Primary
1058
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001188511
—
DE
Enumeration date
07/15/2006
Last updated
03/28/2019
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