Healthcare Provider Details

I. General information

NPI: 1881669273
Provider Name (Legal Business Name): ERLIN MANOR NURSING HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 ERLIN TERRACE
TEWKSBURY MA
01876-2666
US

IV. Provider business mailing address

51 SUMMER STREET
ROWLEY MA
01969-1833
US

V. Phone/Fax

Practice location:
  • Phone: 978-851-3121
  • Fax: 978-640-0981
Mailing address:
  • Phone: 978-948-7383
  • Fax: 978-948-3421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0808
License Number StateMA

VIII. Authorized Official

Name: DEBORAH KLOCK
Title or Position: PRESIDENT
Credential:
Phone: 978-948-7383