Healthcare Provider Details

I. General information

NPI: 1831294131
Provider Name (Legal Business Name): HEBREW REHABILITATION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 11/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CENTRE ST
ROSLINDALE MA
02131-1011
US

IV. Provider business mailing address

1200 CENTRE ST
ROSLINDALE MA
02131-1011
US

V. Phone/Fax

Practice location:
  • Phone: 617-363-8211
  • Fax: 617-363-8913
Mailing address:
  • Phone: 617-363-8211
  • Fax: 617-363-8913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License Number2290
License Number StateMA

VIII. Authorized Official

Name: MR. LEN FISHMAN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 617-363-8211