Healthcare Provider Details

I. General information

NPI: 1356496947
Provider Name (Legal Business Name): SHERRILL HOUSE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 S HUNTINGTON AVE
BOSTON MA
02130-4885
US

IV. Provider business mailing address

135 S HUNTINGTON AVE
JAMAICA PLAIN MA
02130-4885
US

V. Phone/Fax

Practice location:
  • Phone: 617-731-2400
  • Fax: 617-735-1781
Mailing address:
  • Phone: 617-731-2400
  • Fax: 617-735-1781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0742
License Number StateMA

VIII. Authorized Official

Name: MR. ROBERT W MARTIN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 617-731-2400