Organization
ELLIS NURSING HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIELLE A FEDERICO (BUSINESS MANGER)
(781) 237-8503
Entity
Organization
Contact information
Practice address
135 ELLIS AVE, NORWOOD, MA 02062-3946
(781) 762-6880
Mailing address
135 ELLIS AVE, NORWOOD, MA 02062-3946
(781) 762-6880
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
0793
MA
261QR0400X
Rehabilitation Clinic/Center
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0908029
—
MA
01
—
2222521101
BCBS
—
01
—
903249
HDHC
—
Enumeration date
09/30/2005
Last updated
01/17/2018
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