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1102 WASHINGTON STREET OPERATOR LLC NPI 1902322092


NPI Information

NPI: 1902322092
Provider Name: 1102 WASHINGTON STREET OPERATOR LLC

Doing Business As: BRAINTREE MANOR HEALTHCARE

Classification: Skilled Nursing Facility - 314000000X
Entity Type: Organization

CLIA Number: 22D2138783

Address:
1102 WASHINGTON ST
BRAINTREE, MA
ZIP 02184
Phone: (781) 848-3100
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1102 WASHINGTON STREET OPERATOR LLC is a skilled nursing facility in Braintree, MA. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. 1102 WASHINGTON STREET OPERATOR LLC NPI is 1902322092. The provider is registered as an organization entity type.
The provider Is Doing Business As Braintree Manor Healthcare.

The provider's business location address is:

1102 WASHINGTON ST
BRAINTREE, MA
ZIP 02184-438
Phone: (781) 848-3100

The provider's authorized official is William H Stephan .
The authorized official title is Cfo and has the following contact phone number (617) 943-7747.

The CLIA number assigned to this NPI record is 22D2138783 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/21/2017 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1314000000XSkilled Nursing FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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