Organization
SOUTH COVE MANOR, INC
Active
Other names
South Cove Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD WONG (PRESIDENT / CEO)
(617) 423-0590
Entity
Organization
Contact information
Practice address
120 SHAWMUT AVENUE, BOSTON, MA 02118-2293
(617) 423-0590
(617) 292-7922
Mailing address
120 SHAWMUT AVENUE, BOSTON, MA 02118-2293
(617) 423-0590
(617) 292-7922
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0876
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0916056
—
MA
Enumeration date
05/23/2005
Last updated
04/01/2014
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