NPIMap

Organization Active NPI

184 Main LLC

Doing business as Royal Fairhaven Nursing & Rehab

  • Skilled Nursing Facility
  • Fairhaven, MA
National Provider Identifier
1902817299
Registry record updated Oct 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
184 MAIN LLC
Doing business as
Royal Fairhaven Nursing & Rehab
Practice address
184 Main Street
Fairhaven, MA 02719
Phone
(508) 997-3193
Fax
(508) 991-5615
NPI assigned
Aug 11, 2006
Last updated
Oct 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2013

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

Authorized official

Name
Paula Reid
Title
Controller
Phone
(508) 743-8159

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0646 MA
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

184 Main Street
Fairhaven, MA 02719

Mailing address

184 Main Street
Fairhaven, MA 02719
Phone (508) 997-3193

Other identifiers 4

IdentifierTypeStateIssuer
5457520OtherMAAETNA
991098OtherMAUNITED HEALTH CARE
001391OtherMASENIOR WHOLE HEALTH
0940119MedicaidMA

Other names 1

  • Royal Fairhaven Nursing & Rehab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070502000009 MA Part A Provider - Skilled Nursing Facility 5991801318 Practice locations: Fairhaven, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902817299. Details of each certification follow.

Skilled nursing facility certification: CCN 225117

Legal name
184 MAIN LLC
Doing business as
ROYAL OF FAIRHAVEN NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 1, 1970
Last certification
Mar 3, 2025
Beds
107
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Royal Healthgroup
Most recent change of ownership
May 1, 2007
Organization structure
LLCProprietary
Incorporated
Jan 15, 2007 in MA
Enrollment address
184 Main St
Fairhaven, MA 02719-3259
Nursing home name
ROYAL OF FAIRHAVEN NURSING CENTER
Affiliated entity
ROYAL HEALTH GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Royal of Fairhaven Nursing CenterCCN 225117 · All quality measures
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 1, 1970
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10773.0 residents per day on average
Chain
Royal Health Group12 facilities in the chain
Penalties (3 years)
1Fines totaling $8,648

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Parkway Pavilion Healthcare15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
James S Mamary Individual 5% Or Greater Direct Ownership Interest May 1, 2007 100%
Kristie Celorier Individual W-2 Managing EmployeeDirector of Ar Sep 25, 2000

Practitioners & affiliated clinicians

Practitioners 2

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 2

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": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382918400000",
    "number": "1902817299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 MAIN STREET",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "02719",
            "telephone_number": "508-997-3193",
            "fax_number": "508-991-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 MAIN STREET",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "02719",
            "telephone_number": "508-997-3193",
            "fax_number": "508-991-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "184 MAIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2013-10-28",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "508-743-8159"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0646",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5457520",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "991098",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENIOR WHOLE HEALTH",
            "identifier": "001391",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0940119",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Royal Fairhaven Nursing & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairhaven, MA

Sources for this page

Verify at the official NPI Registry.