Charlton Manor Rest Home Inc

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

1059 Issued in MA

Legal business name

CHARLTON MANOR REST HOME INC

Practice address

12 Town Farm Rd
Charlton, MA 01507-1556

Phone

(508) 248-5136

NPI assigned

Mar 21, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carolyn Iandoli

Title

Administrator

Phone

(508) 248-5136

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962528968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 216",
            "city": "ROCHDALE",
            "state": "MA",
            "postal_code": "015420216",
            "telephone_number": "508-248-5136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 TOWN FARM RD",
            "city": "CHARLTON",
            "state": "MA",
            "postal_code": "015071556",
            "telephone_number": "508-248-5136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLTON MANOR REST HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IANDOLI",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "508-248-5136"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "MA",
            "license": "1059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "5507618",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Caron, MSW
• Emly Casey
• Lori Jean Ceppetelli
• Charlton Family Dental PC
• Charlton Family Practice
• Charlton Manor Rest Home LLC
• Charlton Optical
• Robert J Cherry, MD
• Julia Cierpich
• Lauryn Ciszek, FNP

• Custodial Care Facility in Charlton, MA
• Providers in Charlton, MA by specialty
• Custodial Care 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.