Organization
184 MAIN LLC
Active
Other names
Royal Fairhaven Nursing & Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA REID (CONTROLLER)
(508) 743-8159
Entity
Organization
Contact information
Practice address
184 MAIN STREET, FAIRHAVEN, MA 02719
(508) 997-3193
(508) 991-5615
Mailing address
184 MAIN STREET, FAIRHAVEN, MA 02719
(508) 997-3193
(508) 991-5615
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
0646
MA
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001391
SENIOR WHOLE HEALTH
MA
05
—
0940119
—
MA
01
—
5457520
AETNA
MA
01
—
991098
UNITED HEALTH CARE
MA
Enumeration date
08/11/2006
Last updated
10/28/2013
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