NPI 1053178582

200 Governors Opco LLC

Organisation Skilled Nursing Facility Medford, MA

Practice location

Address: 200 Governors Ave, Medford, MA 02155-1644
Phone: (781) 391-5400

Authorised official

Name: Eliyahu Mirlis
Title: Owner
Phone: (732) 961-8491

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X

Other Skilled Nursing Facility providers in Massachusetts →

Registry record

NPI: 1053178582
Entity type: Organization
NPI issued: 1 Mar 2024
Record last updated: 1 Mar 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.