Healthcare Provider Details

I. General information

NPI: 1508386897
Provider Name (Legal Business Name): NEB OPERATOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 FULTON ST
BOSTON MA
02109-1402
US

IV. Provider business mailing address

635 DUQUESNE BLVD
BRICK NJ
08723-5073
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-9700
  • Fax:
Mailing address:
  • Phone: 732-903-1958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MINDEE POSEN
Title or Position: CONTROLLER
Credential: CPA
Phone: 732-903-1958