Healthcare Provider Details

I. General information

NPI: 1669744413
Provider Name (Legal Business Name): SNH SE SG TENANT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 10/11/2021
Certification Date: 10/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 LAKE HUNTER CIRCLE
MOUNT PLEASANT SC
29464-5417
US

IV. Provider business mailing address

255 WASHINGTON STREET, SUITE 300 2 NEWTON PLACE
NEWTON MA
02458-2076
US

V. Phone/Fax

Practice location:
  • Phone: 843-388-2030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER F. MINTZER
Title or Position: PRESIDENT & CHIEF OPERATING OFFICER
Credential:
Phone: 617-796-8350