Healthcare Provider Details

I. General information

NPI: 1447203641
Provider Name (Legal Business Name): SNH SE TENANT TRS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 10/11/2021
Certification Date: 10/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 KATHERINE BLVD
PALM HARBOR FL
34684-3661
US

IV. Provider business mailing address

255 WASHINGTON STREET 2 NEWTON PLACE
NEWTON MA
02458
US

V. Phone/Fax

Practice location:
  • Phone: 949-581-6111
  • Fax: 727-787-1506
Mailing address:
  • Phone: 703-854-0823
  • Fax: 703-854-0164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number15250951
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER F MINTZER
Title or Position: PRESIDENT & CHIEF OPERATING OFFICER
Credential:
Phone: 617-796-8350