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General NPI Number Information
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NPI Number | 1891780268
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Entity Type | Organization
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Legal Business Name | CHELSEA JEWISH NURSING HOME, INC.
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 06/27/2019
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Provider Practice Location Address
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Address Line | 17 LAFAYETTE AVE
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City | CHELSEA
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State | MA
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Zip | 02150-2010
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Country | US
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Telephone | 617-884-6766
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Fax | 617-887-0618
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Provider Business Mailing Address
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Address Line | 17 LAFAYETTE AVE
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City | CHELSEA
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State | MA
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Zip | 02150-2010
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Country | US
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Telephone | 617-884-6766
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Fax | 617-887-0618
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ADAM S. BERMAN
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Credential |
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Telephone | 978-471-5146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 862
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0559
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License Number State | MA
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