Healthcare Provider Details

I. General information

NPI: 1053436154
Provider Name (Legal Business Name): BEACON REHABILITATION & NURSING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 CORY ROAD
BRIGHTON MA
02135-8244
US

IV. Provider business mailing address

52 ACCORD PARK DR
NORWELL MA
02061-1628
US

V. Phone/Fax

Practice location:
  • Phone: 617-731-0515
  • Fax: 617-731-0510
Mailing address:
  • Phone: 781-878-6700
  • Fax: 781-878-9807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number02YF
License Number StateMA

VIII. Authorized Official

Name: MICHAEL WELCH
Title or Position: MANAGING MEMBER
Credential:
Phone: 781-878-6700