Organization
FAIRMOUNT REST HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN MARDEN (OWNER)
(617) 361-5150
Entity
Organization
Contact information
Practice address
172 FAIRMOUNT AVE, 172 FAIRMOUNT AVE, HYDE PARK, MA 02136-3506
(617) 361-5150
(617) 361-7951
Mailing address
172 FAIRMOUNT AVE, 172 FAIRMOUNT AVE, HYDE PARK, MA 02136-3506
(617) 361-5150
(617) 361-7951
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
1387
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5505739
—
MA
Enumeration date
02/22/2007
Last updated
08/22/2020
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