Organization
BANE COLONIAL, LLC
Active
Other names
Colonial Rehabilitation and Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARRISON BANE (VICE PRESIDENT OF OPERATIONS)
(781) 878-6700
Entity
Organization
Contact information
Practice address
125 BROAD ST, WEYMOUTH, MA 02188-2336
(781) 337-3121
(781) 337-9831
Mailing address
350 GRANITE ST STE 2203, BRAINTREE, MA 02184-4963
(781) 474-2263
(781) 871-3986
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110117821A
—
MA
01
—
70012222205201
BLUE CROSS
MA
Enumeration date
04/07/2016
Last updated
07/19/2021
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