Organization
BEAR MT LOWELL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WYNNE JR. (MEMBER/CFO)
(860) 880-8202
Entity
Organization
Contact information
Practice address
500 WENTWORTH AVE, LOWELL, MA 01852-4937
(978) 458-1271
Mailing address
130 S MAIN ST STE 203, THOMASTON, CT 06787-1741
(860) 880-8202
(860) 880-8205
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/20/2019
Last updated
03/20/2019
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