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NPI Code Detail

MEDICARE: THE NORTHEAST HEALTH GROUP, INC

MEDICARE: THE NORTHEAST HEALTH GROUP, 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
1314000000XSkilled Nursing Facility0835MA

Other Identifiers

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

General Provider Information

NPI Number : 1679577175
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE NORTHEAST HEALTH GROUP, INC
Provider Business Mailing Address
First Line : 1675 PALM BEACH LAKES BLVD
Second Line : SUITE 900
City : WEST PALM BEACH
State : FL
Zip : 33401
Country : US
Telephone Number : 561-801-7600
Fax Number : 414-268-4811
Provider Business Practice Location Address
First Line : 546 CHICOPEE ST
Second Line :
City : CHICOPEE
State : MA
Zip : 01013-2148
Country : US
Telephone Number : 413-536-2540
Fax Number : 413-532-6445
Authorized Official
Title or Position : PRESIDENT
Name : HOWARD JAFFE
Credential :
Telephone Number : 215-346-6454
Provider Enumeration Date : 06/13/2005
Last Update Date : 10/05/2012

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Directions to “THE NORTHEAST HEALTH GROUP, INC ” Practice Location

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