Healthcare Provider Details

I. General information

NPI: 1013902881
Provider Name (Legal Business Name): CATHOLIC MEMORIAL HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 01/11/2022
Certification Date: 01/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2446 HIGHLAND AVE
FALL RIVER MA
02720-4504
US

IV. Provider business mailing address

2446 HIGHLAND AVE
FALL RIVER MA
02720-4504
US

V. Phone/Fax

Practice location:
  • Phone: 508-679-0011
  • Fax: 508-672-5858
Mailing address:
  • Phone: 508-679-0011
  • Fax: 508-672-5858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number867
License Number StateMA

VIII. Authorized Official

Name: JOANNE ROQUE
Title or Position: CEO
Credential:
Phone: 508-679-8154