Provider Demographics
NPI:1487547543
Name:OC MILFORD GARDENS LLC
Entity type:Organization
Organization Name:OC MILFORD GARDENS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:AZRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-500-8619
Mailing Address - Street 1:10 VETERANS MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-2900
Mailing Address - Country:US
Mailing Address - Phone:508-473-6414
Mailing Address - Fax:
Practice Address - Street 1:10 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2900
Practice Address - Country:US
Practice Address - Phone:508-473-6414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility