Healthcare Provider Details

I. General information

NPI: 1184701963
Provider Name (Legal Business Name): QUEEN ANNE NURSING HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 10/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 RECREATION PARK DR
HINGHAM MA
02043-4206
US

IV. Provider business mailing address

50 RECREATION PARK DR
HINGHAM MA
02043-4206
US

V. Phone/Fax

Practice location:
  • Phone: 781-749-4982
  • Fax: 781-740-4283
Mailing address:
  • Phone: 781-749-4982
  • Fax: 781-740-4283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0834
License Number StateMA

VIII. Authorized Official

Name: RICHARD H. STARR
Title or Position: OWNER
Credential: ADMINISTRATOR
Phone: 781-749-4982