KRE HUSKY WALTHAM LICENSEE LLC (NPI# 1013575752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013575752 |
| Entity Type | Organization |
| Organization Name | KRE HUSKY WALTHAM LICENSEE LLC |
| Practice Address |
126 Smith St Waltham MA 02451-1300 |
| Mailing Address |
201 Jones Rd Fl 3 Waltham MA 02451-1600 |
| Practice Telephone | 7816097996 |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2019-05-29 |
| Authorized Official Name | MR. THOMAS H. GRAPE (PRESIDENT) |
| Authorized Official Telephone | 7814897100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Street Address |
126 SMITH ST |
| City | WALTHAM |
| State | MA |
| Zip Code | 02451-1300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013032861 | B-xii Waltham LLC | Assisted Living Facility | 126 Smith St, Waltham, MA 02451-1300 | 2007-03-20 |
| 1376176750 | Kre-bsl Husky Waltham Operations LLC | Assisted Living Facility | 126 Smith St, Waltham, MA 02451-1300 | 2020-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719190 | Haeun Yang | Behavior Technician | 303 Wyman Street Suite 354, 344, 345, Waltham, MA 02451 | 2019-09-16 |
| 1982252599 | Sinclair Fashaw-braxton | Behavior Technician | 303 Wyman Street, Suite 354, 344, 345, Waltham, MA 02451 | 2019-08-27 |
| 1245715879 | Annie F Friedman | Social Worker | Extended Stay America, 32 4the Avenue, Waltham, MA 02451 | 2018-09-28 |
| 1760964118 | Elizabeth Boardman Harris | Social Worker | 60 Hickory Drive 4th Floor, Waltham, MA 02451 | 2018-09-02 |
| 1760960959 | Patriot Urgent Care Professionals, PC | General Practice | 1030 Main Street, Unit 2, Waltham, MA 02451 | 2018-07-31 |
| 1962998013 | Leighann Teresa Healy | Behavior Technician | 303 Wyman Suite 300, Waltham, MA 02451 | 2018-07-02 |
| 1194234492 | Bruna Rossi Hoffman | Dentist | 12 Grant Place, Apt 1, Waltham, MA 02451 | 2017-09-29 |
| 1265959159 | Matthew C Page-shelton | Counselor | 2208 Stearns Hill Road, Waltham, MA 02451 | 2017-08-23 |
| 1306380837 | Sherri Lynn Duquette | Behavior Technician | 1430 Main Street, Waltham, MA 02451 | 2016-12-19 |
| 1649628728 | Keren Matveev | Family Medicine | 75 Third Avenue, First Floor, Waltham, MA 02451 | 2016-05-30 |
| Find all providers in zip 02451 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265962658 | Wincare LLC | Assisted Living Facility | 704 Beaver St, Waltham, MA 02452-5648 | 2017-06-18 |
| 1013032861 | B-xii Waltham LLC | Assisted Living Facility | 126 Smith St, Waltham, MA 02451-1300 | 2007-03-20 |
| 1831293240 | Piety Corner Nursing Home | Assisted Living Facility | 325 Bacon St, Waltham, MA 02451-7519 | 2006-09-08 |
| 1376176750 | Kre-bsl Husky Waltham Operations LLC | Assisted Living Facility | 126 Smith St, Waltham, MA 02451-1300 | 2020-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396370649 | Roderick Family LLC | Assisted Living Facility | 46 Lincoln St, Winthrop, MA 02152-2151 | 2020-03-06 |
| 1093355083 | Naafay, LLC | Assisted Living Facility | 265 Bear Hill Rd, North Andover, MA 01845-2115 | 2020-01-08 |
| 1184284705 | Erlin Manor Assisted Living, Inc. | Assisted Living Facility | 10b Erlin Ter, Tewksbury, MA 01876-2685 | 2019-06-17 |
| 1811465974 | Shi-iii Wrentham LLC | Assisted Living Facility | 30 Ledgeview Way, Attn: Executive Director Or Dba, Wrentham, MA 02093 | 2018-11-07 |
| 1023516465 | D'youville Leadership Solutions | Assisted Living Facility | 1085 Varnum Ave, Lowell, MA 01854-1133 | 2018-01-31 |
| 1457868622 | B-x Worcester LLC | Assisted Living Facility | 340 May St, Worcester, MA 01602-1800 | 2018-01-09 |
| 1841707098 | B-x Agawam LLC | Assisted Living Facility | 153 Cardinal Dr, Agawam, MA 01001-2182 | 2018-01-09 |
| 1811404544 | B-xi Operations Holding Company LLC | Assisted Living Facility | Benchmark At Robbins Brook, 10 Devon Drive, Acton, MA 01720 | 2018-01-03 |
| 1558876060 | Belchertown Heights Alf Lp | Assisted Living Facility | 99 Front Street, Belchertown, MA 01007 | 2017-12-06 |
| 1811434491 | Aniket Chakrabarti | Assisted Living Facility | 243 Church St Ste E, Pembroke, MA 02359-1962 | 2017-01-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.