Kre Husky Billerica Licensee LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

KRE HUSKY BILLERICA LICENSEE LLC

Practice address

20 Charnstaff LN
Billerica, MA 01821-6702

Phone

(978) 228-3595

NPI assigned

May 24, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Thomas H. Grape

Title

President

Phone

(781) 489-7100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558656000000",
    "number": "1639736622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 JONES RD STE 300",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CHARNSTAFF LN",
            "city": "BILLERICA",
            "state": "MA",
            "postal_code": "018216702",
            "telephone_number": "978-228-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRE HUSKY BILLERICA LICENSEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-24",
        "last_updated": "2019-05-24",
        "status": "A",
        "authorized_official_last_name": "GRAPE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-489-7100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Kelly
• Christine Kensicki, MSW
• Akhtar Khan, D.M.D,
• Melissa Rose Koesterich
• Michele Lee Krasinski, RN
• Kre-BSL Husky Billerica Operations LLC
• Jennifer Kulins, JENNIFER KULINS LPN
• Lawrence Newman MD & Penelope Hall MD
• Le Vision
• Thuyanh Dang Le, O.D.

• All providers in Billerica, MA
• Assisted Living Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; 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.