MEDICARE: CHESTNUT WOODS OPERATOR 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
1	314000000X	Skilled Nursing Facility		MA

General Provider Information

NPI Number	:	1932524204
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHESTNUT WOODS OPERATOR LLC

Provider Business Mailing Address
First Line	:	PO BOX 1030
Second Line	:
City	:	BRICK
State	:	NJ
Zip	:	08723-0090
Country	:	US
Telephone Number	:	732-606-5973
Fax Number	:	732-608-2976

Provider Business Practice Location Address
First Line	:	73 CHESTNUT ST
Second Line	:
City	:	SAUGUS
State	:	MA
Zip	:	01906-1605
Country	:	US
Telephone Number	:	781-233-8123
Fax Number	:	732-608-2976

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MR. NACHUM ROKEACH
Credential	:
Telephone Number	:	732-232-9217

Provider Enumeration Date	:	02/24/2014
Last Update Date	:	04/03/2024

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