1639151202 NPI number — REHAB NEW ENGLAND PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639151202 NPI number — REHAB NEW ENGLAND PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REHAB NEW ENGLAND PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SENIOR REHAB CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639151202
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/15/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 FATHER DEVALLES BLVD
Provider Second Line Business Mailing Address:
SUITE 401
Provider Business Mailing Address City Name:
FALL RIVER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02723-1511
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-673-5500
Provider Business Mailing Address Fax Number:
508-673-6500

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 OLD DIAMOND HILL ROAD
Provider Second Line Business Practice Location Address:
SENIOR REHAB CARE
Provider Business Practice Location Address City Name:
CUMBERLAND
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02864
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-673-5500
Provider Business Practice Location Address Fax Number:
508-673-6500
Provider Enumeration Date:
11/18/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SIROIS
Authorized Official First Name:
JOAN
Authorized Official Middle Name:
F
Authorized Official Title or Position:
OPERATIONS EXECUTIVE
Authorized Official Telephone Number:
508-673-5500

Provider Taxonomy Codes

  • Taxonomy code: 261QR0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)