Organization
120 MURRAY STREET OPERATIONS LLC
Active
Parent organization
SUMMIT CARE LLC
Other names
Glen Ridge Nursing Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUMMIT CARE LLC
Authorized official
MICHAEL T BERG (ASSISTANT SECRETARY)
(505) 468-4742
Entity
Organization
Contact information
Practice address
120 MURRAY STREET, MEDFORD, MA 02155
(781) 391-0800
(781) 391-0801
Mailing address
120 MURRAY STREET, MEDFORD, MA 02155
(781) 391-0800
(781) 391-0801
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
00000
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49447611423151
AETNA
MA
Enumeration date
08/05/2015
Last updated
03/19/2019
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