Provider Demographics
NPI:1295871333
Name:GUARINO GRIMES, LLC
Entity type:Organization
Organization Name:GUARINO GRIMES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:GRIMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-373-5697
Mailing Address - Street 1:194 BOARDMAN ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6405
Mailing Address - Country:US
Mailing Address - Phone:978-373-5697
Mailing Address - Fax:978-373-3030
Practice Address - Street 1:194 BOARDMAN ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6405
Practice Address - Country:US
Practice Address - Phone:978-373-5697
Practice Address - Fax:978-373-3030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0271314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0929212Medicaid
MA225743Medicare Oscar/Certification
MA225743Medicare ID - Type UnspecifiedI.D. NUMBER