Park Place LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0500 Issued in MA

Legal business name

PARK PLACE LLC

Doing business as

Park Place

Practice address

113 Central Ave
Hyde Park, MA 02136-3021

Phone

(617) 361-2388

Fax

(617) 364-3112

NPI assigned

Oct 4, 2005

Last updated

Feb 12, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Laura McDonnell

Title

Corporate Business Office Manager

Phone

(978) 420-1500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Park Place Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265932800000",
    "number": "1215924303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 CENTRAL AVE",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021363021",
            "telephone_number": "617-361-2388",
            "fax_number": "617-364-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 CENTRAL AVE",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021363021",
            "telephone_number": "617-361-2388",
            "fax_number": "617-364-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2010-02-12",
        "status": "A",
        "authorized_official_last_name": "MCDONNELL",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CORPORATE BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "978-420-1500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0925896",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Abieyuwa Omoroghomwan, LPN
• Edith Onwuakor
• Gecinda Orelus
• Assumpta Uzoma Orjiakor
• Brie Ostreicher
• Ryan Park, DMD
• Parkwell Healthcare LLC (Parkwell)
• Gunjanbhai Rameshbhai Patel, DMD
• Marie Auxiliatrice Paul
• Patrick Evans Paul

• Skilled Nursing Facility in Hyde Park, MA
• Providers in Hyde Park, MA by specialty
• Skilled Nursing Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.