30 Princeton Boulevard Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0701 Issued in MA

Legal business name

30 PRINCETON BOULEVARD OPERATIONS LLC

Doing business as

Willow Manor

Practice address

30 Princeton Blvd
Lowell, MA 01851-2405

Phone

(978) 454-8086

Fax

(978) 453-9772

NPI assigned

Dec 4, 2007

Last updated

Oct 6, 2025By 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

Michael Berg

Title

Secretary

Phone

(610) 444-6350

Specialties & licenses 1

Addresses

Other names 1

• Willow Manor Doing business as

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759708800000",
    "number": "1649452467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "610-925-4436",
            "fax_number": "610-925-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PRINCETON BLVD",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018512405",
            "telephone_number": "978-454-8086",
            "fax_number": "978-453-9772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "30 PRINCETON BOULEVARD OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "610-444-6350"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willow Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Lowell, MA
• Providers in Lowell, 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 Oct 6, 2025; 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.