Healthcare Provider Details

I. General information

NPI: 1295746188
Provider Name (Legal Business Name): STONE INSTITUTE AND NEWTON HOME FOR AGED PEOPLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 10/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 ELLIOT ST
NEWTON UPPER FALLS MA
02464-1201
US

IV. Provider business mailing address

101 SUN AVE NE COMPLIANCE DEPARTMENT
ALBUQUERQUE NM
87109-4373
US

V. Phone/Fax

Practice location:
  • Phone: 617-527-0023
  • Fax: 617-965-7531
Mailing address:
  • Phone: 505-468-5604
  • Fax: 505-468-4681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0391
License Number StateMA

VIII. Authorized Official

Name: BRIAN MEDEIROS
Title or Position: CORPORATE CONTROLLER
Credential:
Phone: 508-898-3490