NPI 1104044981

Village Rest Home INC

Organisation Exclusive Provider Organization Brockton, MA

Practice location

Address: 197 W Chestnut St, Brockton, MA 02301-6753
Phone: (508) 583-0040
Mailing address: 30 Sinclair Rd, Brockton, MA 02302-4452

Authorised official

Name: Guy Marcellus
Title: Director
Phone: (508) 583-0040

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

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Registry record

NPI: 1104044981
Entity type: Organization
NPI issued: 24 Apr 2007
Record last updated: 22 Aug 2020

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.