Connemara Senior Living at Campello Crossing, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CONNEMARA SENIOR LIVING AT CAMPELLO CROSSING, INC.

Practice address

25 E Nilsson St
Brockton, MA 02301-6604

Phone

(617) 686-1099

NPI assigned

Jun 14, 2017

Organization subpart

No

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

Authorized official

Name

John Patrick Burke

Title

President

Phone

(617) 686-1099

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497398400000",
    "number": "1235669003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 E NILSSON ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023016604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E NILSSON ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023016604",
            "telephone_number": "617-686-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNEMARA SENIOR LIVING AT CAMPELLO CROSSING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-14",
        "last_updated": "2017-06-14",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-686-1099"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Guerda Conserve, DEVELOPMENTAL SPECIA
• Katiana Constant

• Assisted Living Facility in Brockton, MA
• Providers in Brockton, MA by specialty
• Assisted Living Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; 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.