Organization
ST. JOSEPH MANOR HEALTH CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER J. KENNEY (CEO/ADMINISTRATOR)
(508) 583-5834
Entity
Organization
Contact information
Practice address
215 THATCHER ST, BROCKTON, MA 02302-3949
(508) 583-5834
(508) 583-8551
Mailing address
215 THATCHER ST, BROCKTON, MA 02302-3949
(508) 583-5834
(508) 583-8551
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
881
MA
314000000X
Skilled Nursing Facility
Primary
0585
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0906166
—
MA
Enumeration date
11/15/2005
Last updated
11/20/2012
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