Organization
AVERY MANOR NURSING, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILYN WEAVER (ASSISTANT SECRETARY)
(502) 596-7563
Entity
Organization
Contact information
Practice address
100 WEST ST, NEEDHAM, MA 02494-1319
(781) 234-6300
(781) 234-6832
Mailing address
680 S 4TH ST, LOUISVILLE, KY 40202-2407
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000023951
BMC HEALTH NET
MA
01
—
0020004
MARTINS POINT
MA
01
—
0926272
MVP
MA
05
—
0927961
—
MA
01
—
2222567401
BLUE CROSS BLUE SHIELD
MA
01
—
637422
MULTIPLAN
MA
01
—
71-00783
CIGNA
MA
01
—
907779
EVERCARE
MA
Enumeration date
08/24/2006
Last updated
04/20/2018
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