Organization
BEAR MT WORCESTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN B WYNNE JR. (MEMBER/CFO)
(860) 880-8202
Entity
Organization
Contact information
Practice address
59 ACTON ST, WORCESTER, MA 01604-4829
(508) 791-3147
Mailing address
130 S MAIN ST STE 203, THOMASTON, CT 06787-1741
(860) 880-8202
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/21/2019
Last updated
03/21/2019
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