SRC Brewster Alf, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SRC BREWSTER ALF, LLC

Practice address

855 Harwich Rd
Brewster, MA 02631-5223

Phone

(508) 896-3252

NPI assigned

Nov 19, 2015

Organization subpart

No

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

Authorized official

Name

Tamilyn Levin

Title

Chief Financial Officer

Phone

(781) 707-9510

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447891200000",
    "number": "1669846358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 KENDRICK ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024942708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 HARWICH RD",
            "city": "BREWSTER",
            "state": "MA",
            "postal_code": "026315223",
            "telephone_number": "508-896-3252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRC BREWSTER ALF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-19",
        "last_updated": "2015-11-19",
        "status": "A",
        "authorized_official_last_name": "LEVIN",
        "authorized_official_first_name": "TAMILYN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "781-707-9510"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael B Singleton, DC
• Brian Rethjen Skea, M.E'D. PHD
• Dianna Lee Smith, MSW
• Jeffrey Sargent Smith, LMHC, LMFT
• Jennifer C Smith
• SRC Brewster SNF, LLC
• Hilary Elizabeth St Pierre, DDS
• Michelle Stevens
• Nicholas James Storer, RDH
• Sharon Stout, L.M.H.C.

• Assisted Living Facility in Brewster, MA
• Providers in Brewster, MA by specialty
• Assisted Living Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; 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.