1992707178 NPI number — YOUVILLE HOSPITAL & REHABILITATION CENTER

Table of content: (NPI 1992707178)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992707178 NPI number — YOUVILLE HOSPITAL & REHABILITATION CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YOUVILLE HOSPITAL & REHABILITATION CENTER
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:
Provider Other Organization Name Type Code:
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:
1992707178
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1575 CAMBRIDGE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMBRIDGE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02138-4308
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-876-4344
Provider Business Mailing Address Fax Number:
617-234-7913

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1575 CAMBRIDGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02138-4308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-876-4344
Provider Business Practice Location Address Fax Number:
617-234-7913
Provider Enumeration Date:
06/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
KELLER
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
J
Authorized Official Title or Position:
VP OF FINANCE/CFO
Authorized Official Telephone Number:
617-876-4344

Provider Taxonomy Codes

  • Taxonomy code: 282E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 900582 . This is a "HARVARD COMMUNITY HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: CA7049 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2222200002 . This is a "REHABILITATION INPATIENT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 30014212 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0222000 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1103105 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 905169 . This is a "TUFTS HEALTH PLAN INPT NO" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 996006 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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