Healthcare Provider Details

I. General information

NPI: 1437102498
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: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1699 SE LYNGATE DR
PORT ST LUCIE FL
34952-5016
US

IV. Provider business mailing address

255 WASHINGTON ST STE 300
NEWTON MA
02458-1634
US

V. Phone/Fax

Practice location:
  • Phone: 772-335-9990
  • Fax: 772-335-9993
Mailing address:
  • Phone: 617-796-8350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF1062096
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER JASON BILOTTO
Title or Position: PRESIDENT & CHIEF EXECUTIVE OFFICER
Credential:
Phone: 617-796-8387