Organization
ISLAND TERRACE, INC.
Active
Other names
Island Terrace Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENTON TOLLES NHA (ADMINISTRATOR)
(508) 947-0151
Entity
Organization
Contact information
Practice address
57 LONG POINT RD, LAKEVILLE, MA 02347-2124
(508) 947-0151
(508) 946-5335
Mailing address
57 LONG POINT RD, LAKEVILLE, MA 02347-2124
(508) 947-0151
(508) 946-5335
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0614
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0911798
—
MA
Enumeration date
09/14/2005
Last updated
11/15/2007
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