Braintree Manor Nursing LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0710 Issued in MA

Legal business name

BRAINTREE MANOR NURSING LLC

Doing business as

Braintree Manor Rehab and Nsg Center

Practice address

1102 Washington St
Braintree, MA 02184-5438

Phone

(781) 848-3100

NPI assigned

Jan 19, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Brad Rolph

Title

Cfo

Phone

(781) 297-8626

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Braintree Manor Rehab and Nsg Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104806710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 KERRY PL",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020624775",
            "telephone_number": "781-619-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 WASHINGTON ST",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845438",
            "telephone_number": "781-848-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAINTREE MANOR NURSING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROLPH",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "781-297-8626",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0926060",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Braintree Manor Rehab and Nsg Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Braintree, MA
• Providers in Braintree, MA by specialty
• Skilled Nursing Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.