Organization
199 ANDOVER STREET OPERATING COMPANY, LLC
Active
Other names
Peabody Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY VAZQUEZ (VP, SPECIAL PROJECTS)
(978) 930-6051
Entity
Organization
Contact information
Practice address
199 ANDOVER STREET ROUTE 114W, PEABODY, MA 01960
(978) 531-0772
(978) 532-4134
Mailing address
199 ANDOVER STREET ROUTE 114W, PEABODY, MA 01960
(978) 531-0772
(978) 532-4134
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0900
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0926825
—
MA
Enumeration date
07/14/2005
Last updated
12/15/2023
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