Healthcare Provider Details

I. General information

NPI: 1528062387
Provider Name (Legal Business Name): DEUTSCHES ALTENHEIM INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 09/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 CENTRE ST
WEST ROXBURY MA
02132-4034
US

IV. Provider business mailing address

2222 CENTRE ST
WEST ROXBURY MA
02132-4034
US

V. Phone/Fax

Practice location:
  • Phone: 617-325-1230
  • Fax: 617-323-7523
Mailing address:
  • Phone: 617-325-1230
  • Fax: 617-323-7523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0740
License Number StateMA

VIII. Authorized Official

Name: MR. MICHAEL B LINCOLN
Title or Position: CEO
Credential:
Phone: 617-325-1230