Healthcare Provider Details

I. General information

NPI: 1548813850
Provider Name (Legal Business Name): PLEASANT BAY OF BREWSTER REHAB CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2019
Last Update Date: 11/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

383 SOUTH ORLEANS ROAD
BREWSTER MA
02631
US

IV. Provider business mailing address

320 NORWOOD PARK SOUTH
NORWOOD MA
02062
US

V. Phone/Fax

Practice location:
  • Phone: 781-255-0531
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CATERINA MINA LABELLA
Title or Position: CFO
Credential:
Phone: 781-255-0531