Organization
KIOSK INC, DBA HAVENWOOD REST HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD LEO DISANTI (PRESIDENT)
(508) 994-3120
Entity
Organization
Contact information
Practice address
251 WALNUT ST, NEW BEDFORD, MA 02740-4964
(508) 994-3120
Mailing address
251 WALNUT ST, NEW BEDFORD, MA 02740-4964
(508) 994-3120
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
5507219
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5507219
—
MA
Enumeration date
09/23/2005
Last updated
08/22/2020
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