Provider Demographics
NPI:1386936474
Name:MANGWA INVESTMENTS INC.
Entity type:Organization
Organization Name:MANGWA INVESTMENTS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSOP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-423-0300
Mailing Address - Street 1:402 COUNTRY CLUB WAY
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02364-4110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:670 COUNTY ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6719
Practice Address - Country:US
Practice Address - Phone:508-994-2400
Practice Address - Fax:508-994-4746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-06
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
225423Medicare Oscar/Certification