Provider Demographics
NPI:1104922566
Name:WILL-MARK NURSING HOMES INC
Entity type:Organization
Organization Name:WILL-MARK NURSING HOMES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:TWOMEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-531-2499
Mailing Address - Street 1:210 LOWELL ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-4201
Mailing Address - Country:US
Mailing Address - Phone:978-531-2499
Mailing Address - Fax:978-531-4154
Practice Address - Street 1:210 LOWELL ST
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-4201
Practice Address - Country:US
Practice Address - Phone:978-531-2499
Practice Address - Fax:978-531-4154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0296314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0910201Medicaid
MA225526Medicare ID - Type Unspecified