National Provider Identifier Database

MARILLAC RESIDENCE INC
Voluntary or Charitable


Contact Information

MARILLAC RESIDENCE, INC
125 OAKLAND ST
WELLESLEY HILLS, MA02481-5338
Phone: 781-997-1124
Fax:
Website:
Specialty Taxonomy Code
* Voluntary or Charitable 251V00000X

* Indicates primary specialty

NPI Profile & details for MARILLAC RESIDENCE, INC

NPI Number 1972630317
Legal business name
LBN
MARILLAC RESIDENCE, INC
Authorized official HELEN SHKNEVSKY - (DIRECTOR OF FISCAL SERVICES)
Entity Organization
Organization subpart No
Enumeration date 02/27/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • MA Medicaid: 5508525

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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