NPIMap

Organization Active NPI

84 Elm St., Inc.

Doing business as Timothy Daniels House

  • Skilled Nursing Facility
  • Holliston, MA
National Provider Identifier
1639230584
Registry record updated Dec 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0374 Issued in MA
Legal business name
84 ELM ST., INC.
Doing business as
Timothy Daniels House
Practice address
84 Elm St
Holliston, MA 01746-2138
Phone
(508) 429-4566
Fax
(508) 429-4581
NPI assigned
Dec 13, 2006
Last updated
Dec 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2011

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

Authorized official

Name
Peter H. Thisse
Title
Controller
Phone
(781) 762-0703

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0374 MA Primary

Addresses

Primary practice location

84 Elm St
Holliston, MA 01746-2138

Mailing address

80 Access Rd
Norwood, MA 02062-5237
Phone (781) 762-0703

Other identifiers 1

IdentifierTypeStateIssuer
0907022MedicaidMA

Other names 1

  • Timothy Daniels House Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041008000687 MA Part A Provider - Skilled Nursing Facility 7719946235 Practice locations: Holliston, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639230584. Details of each certification follow.

Skilled nursing facility certification: CCN 225709

Legal name
84 ELM ST INC.
Doing business as
TIMOTHY DANIELS HOUSE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 1, 1996
Last certification
Mar 6, 2025
Beds
40
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Enrollment address
84 Elm St
Holliston, MA 01746-2138
Nursing home name
TIMOTHY DANIELS HOUSE
Affiliated entity
REHABILITATION ASSOCIATES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Timothy Daniels HouseCCN 225709 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 1, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4029.3 residents per day on average
Chain
Rehabilitation Associates6 facilities in the chain
Penalties (3 years)
1Fines totaling $0

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

84 Elm St
Holliston, MA 01746
Phone (508) 429-4566

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Marion Thisse Individual 5% Or Greater Direct Ownership Interest Mar 14, 2024 100%
Thomas R Bunker Individual Operational/Managerial ControlAdminstrator May 13, 2016
Peter H Thisse Individual Corporate DirectorController Jan 2, 1990
Rehabilitation Associates Inc Organization, Norwood, MA Corporation, Management services company Operational/Managerial Control May 24, 1972 100%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323993600000",
    "number": "1639230584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 ACCESS RD",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625237",
            "telephone_number": "781-762-0703",
            "fax_number": "781-762-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 ELM ST",
            "city": "HOLLISTON",
            "state": "MA",
            "postal_code": "017462138",
            "telephone_number": "508-429-4566",
            "fax_number": "508-429-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "84 ELM ST., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2011-12-16",
        "status": "A",
        "authorized_official_last_name": "THISSE",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "781-762-0703"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0907022",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Timothy Daniels House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holliston, MA

Sources for this page

Verify at the official NPI Registry.