MEDICARE: DARTMOUTH HOUSE NURSING HOME INC

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
1	314000000X	Skilled Nursing Facility	3969	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164497459
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DARTMOUTH HOUSE NURSING HOME INC

Provider Business Mailing Address
First Line	:	51 SUMMER STREET
Second Line	:
City	:	ROWLEY
State	:	MA
Zip	:	01969-1833
Country	:	US
Telephone Number	:	978-948-7383
Fax Number	:	978-948-3421

Provider Business Practice Location Address
First Line	:	567 DARTMOUTH ST
Second Line	:
City	:	S DARTMOUTH
State	:	MA
Zip	:	02748-1826
Country	:	US
Telephone Number	:	508-997-7787
Fax Number	:	508-997-5598

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DEBORAH KLOCK
Credential	:
Telephone Number	:	978-948-7383

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	08/22/2020

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