Organization
MARIAN MANOR, FOR THE AGED AND INFIRM, INC.
Active
Other names
Marian Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS A. MILLER (CFO)
(617) 268-3333
Entity
Organization
Contact information
Practice address
130 DORCHESTER STREET, SOUTH BOSTON, MA 02127-2642
(617) 268-3333
(617) 268-4589
Mailing address
130 DORCHESTER ST, SOUTH BOSTON, MA 02127-2642
(617) 268-3333
(617) 268-4589
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0506
MA
314000000X
Skilled Nursing Facility
225415
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110025765A
—
MA
Enumeration date
09/20/2006
Last updated
03/31/2015
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