Organization Active NPI

St. Joseph Manor Health Care, Inc.

  • Skilled Nursing Facility
  • Brockton, MA
National Provider Identifier
1275515439
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0585 Issued in MA
Legal business name
ST. JOSEPH MANOR HEALTH CARE, INC.
Practice address
215 Thatcher St
Brockton, MA 02302-3949
Phone
(508) 583-5834
Fax
(508) 583-8551
NPI assigned
Nov 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Authorized official

Name
Mr. Christopher J. Kenney
Title
Ceo/Administrator
Phone
(508) 583-5834

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 881 MA
Skilled Nursing Facility 314000000X 0585 MA Primary

Addresses

Primary practice location

215 Thatcher St
Brockton, MA 02302-3949

Mailing address

215 Thatcher St
Brockton, MA 02302-3949
Phone (508) 583-5834

Other identifiers 1

IdentifierTypeStateIssuer
0906166MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070510000167 MA Part A Provider - Skilled Nursing Facility 8426154220 Practice locations: Brockton, MA

Skilled nursing facility certification: CCN 225414

Legal name
ST JOSEPH MANOR HEALTH CARE INC
Doing business as
ST JOSEPH MANOR HEALTH CARE INC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1990
Last certification
Nov 6, 2024
Beds
118
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Covenant Health
Organization structure
CorporationNon-profit
Incorporated
May 9, 1975 in MA
Enrollment address
215 Thatcher St
Brockton, MA 02302-3949
Nursing home name
ST JOSEPH MANOR HEALTH CARE INC

Care Compare: Nursing home

Medicare Care Compare
Listed as
St Joseph Manor Health Care IncCCN 225414 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jul 1, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
118104.1 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0911336St Joseph Manor Health Care Inc215 Thatcher Street, Brockton, MA 02302Certificate of waiverJan 31, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Paul Arenburg Individual Corporate OfficerVice-Chairperson May 1, 2014 7.14%
Mary Valliere Individual Corporate DirectorBoard Member Sep 27, 2013 7.14%
Ruth Dauginikas Individual Corporate DirectorMember May 1, 2013 7.14%
Angela S Cardoso-Fontes Individual Corporate DirectorMember Jun 27, 2014 7.14%
James Keane Individual Corporate OfficerCeo/Administrator Oct 3, 2016
Poor Sisters of Jesus Crucified and the Sorrowful Mother, Inc Organization, Brockton, MA Created for acquisition, Non-profit 5% Or Greater Mortgage Interest Sep 27, 2013 100%
Richard Crowley Individual Corporate DirectorBoard Member Sep 27, 2013 7.14%
Nicole L Castillo Individual Corporate DirectorSystem Director Post Acute Ar May 18, 2018
W-2 Managing EmployeeSystem Director Post Acute Ar May 18, 2018
Covenant Health Organization, Tewksbury, MA Corporation Other Sep 27, 2013 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1275515439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 THATCHER ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023949",
            "telephone_number": "508-583-5834",
            "fax_number": "508-583-8551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 THATCHER ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023949",
            "telephone_number": "508-583-5834",
            "fax_number": "508-583-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH MANOR HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "KENNEY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "508-583-5834",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MA",
            "license": "881",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0906166",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.