Healthcare Provider Details

I. General information

NPI: 1700903499
Provider Name (Legal Business Name): YOUVILLE HOSPITAL AND REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 CAMBRIDGE ST
CAMBRIDGE MA
02138-4308
US

IV. Provider business mailing address

1575 CAMBRIDGE ST
CAMBRIDGE MA
02138-4308
US

V. Phone/Fax

Practice location:
  • Phone: 617-876-4344
  • Fax: 617-234-7900
Mailing address:
  • Phone: 617-876-4344
  • Fax: 617-234-7900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL KELLER
Title or Position: VICE PRESIDENT CFO
Credential:
Phone: 617-876-4344