Organization
SHI-III WRENTHAM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND DIOGUARDI (COO/CFO)
(516) 496-1505
Entity
Organization
Contact information
Practice address
30 LEDGEVIEW WAY, ATTN: EXECUTIVE DIRECTOR OR DBA, WRENTHAM, MA 02093
(774) 210-8108
(774) 847-9725
Mailing address
100 JERICHO QUADRANGLE STE 142, JERICHO, NY 11753-2702
(516) 496-1505
(516) 496-1509
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/07/2018
Last updated
08/04/2020
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