Organization
KRE HUSKY PROVIDENCE LICENSEE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS H. GRAPE (PRESIDENT)
(781) 489-7100
Entity
Organization
Contact information
Practice address
700 SMITH ST, PROVIDENCE, RI 02908-3500
(401) 648-0124
Mailing address
201 JONES RD FL 3, WALTHAM, MA 02451-1600
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
06/14/2019
Last updated
06/14/2019
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