Healthcare Provider Details

I. General information

NPI: 1144328691
Provider Name (Legal Business Name): SANCTA MARIA HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 04/21/2022
Certification Date: 04/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

799 CONCORD AVE
CAMBRIDGE MA
02138-1048
US

IV. Provider business mailing address

799 CONCORD AVE
CAMBRIDGE MA
02138-1048
US

V. Phone/Fax

Practice location:
  • Phone: 617-868-2200
  • Fax: 617-868-2851
Mailing address:
  • Phone: 617-868-2200
  • Fax: 617-868-2851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0927
License Number StateMA

VIII. Authorized Official

Name: THOMAS GOMES
Title or Position: ADMINISTRATOR
Credential:
Phone: 617-868-2200