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NPI Code Detail

MEDICARE: SNH VA TENANT LLC

MEDICARE: SNH VA TENANT LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living Facility

General Provider Information

NPI Number : 1124676846
Entity Type Code : Organization
Provider Name (Legal Business Name) : SNH VA TENANT LLC
Provider Business Mailing Address
First Line : 255 WASHINGTON ST STE 300
Second Line :
City : NEWTON
State : MA
Zip : 02458-1634
Country : US
Telephone Number : 617-796-8350
Fax Number :
Provider Business Practice Location Address
First Line : 2856 FOREHAND DR
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23323-2006
Country : US
Telephone Number : 757-487-9400
Fax Number : 757-487-7309
Authorized Official
Title or Position : PRESIDENT & CHIEF OPERATING OFFICER
Name : JENNIFER F. MINTZER
Credential :
Telephone Number : 617-796-8350
Provider Enumeration Date : 08/27/2019
Last Update Date : 05/07/2020

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Directions to “SNH VA TENANT LLC ” Practice Location

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