Organization
KENOZA MANOR CONVALESCENT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM BARRY (ADMINISTRATOR)
(978) 372-7700
Entity
Organization
Contact information
Practice address
190 NORTH AVE, HAVERHILL, MA 01830-2238
(978) 372-7700
(978) 521-1737
Mailing address
190 NORTH AVE, HAVERHILL, MA 01830-2238
(978) 372-7700
(978) 521-1737
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0921092
—
MA
Enumeration date
10/28/2005
Last updated
08/12/2008
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