MEDICARE: ELIZABETH SETON RESIDENCE 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	854	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	:	1457357659
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELIZABETH SETON RESIDENCE INC.

Provider Business Mailing Address
First Line	:	125 OAKLAND ST
Second Line	:
City	:	WELLESLEY HILLS
State	:	MA
Zip	:	02481-5338
Country	:	US
Telephone Number	:	781-237-2161
Fax Number	:	781-431-2589

Provider Business Practice Location Address
First Line	:	125 OAKLAND ST
Second Line	:
City	:	WELLESLEY HILLS
State	:	MA
Zip	:	02481-5338
Country	:	US
Telephone Number	:	781-237-2161
Fax Number	:	781-431-2589

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. LORI FERRANTE
Credential	:
Telephone Number	:	781-997-1130

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	07/25/2017

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