Organization
MARY LYON NURSING AND REHABILITATION CENTER
Active
Other names
Radius 91 Lyons Operating, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA DECOTEAU (ACCOUNTS RECEIVABLE REGIONAL MANAGE)
(413) 335-3318
Entity
Organization
Contact information
Practice address
34 MAIN ST, HAMPDEN, MA 01036-9642
(413) 566-5511
(413) 566-8488
Mailing address
34 MAIN ST, HAMPDEN, MA 01036-9642
(413) 566-5511
(413) 566-8488
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0057
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0929191
—
MA
Enumeration date
10/25/2005
Last updated
06/24/2008
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