OrganizationActive
200 Governors Opco LLC
NPI 1053178582 · Skilled Nursing Facility · Medford, MA
Provider details
- NPI number
- 1053178582
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Eliyahu Mirlis, Owner(732) 961-8491
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
200 Governors Ave
Medford, MA 02155-1644
Phone: (781) 391-5400
Approximate (ZIP-level) locationGet directions
Mailing address
200 Governors Ave
Medford, MA 02155-1644
Registry dates
- Enumerated
- 2024-03-01
- Last updated
- 2024-03-01
- Certified
- 2024-03-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.