Organization
CHARLTON MANOR REST HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN IANDOLI (ADMINISTRATOR)
(508) 248-5136
Entity
Organization
Contact information
Practice address
12 TOWN FARM RD, CHARLTON, MA 01507-1556
(508) 248-5136
Mailing address
PO BOX 216, ROCHDALE, MA 01542-0216
(508) 248-5136
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
1059
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5507618
PROVIDER NUMBER
MA
Enumeration date
03/21/2007
Last updated
08/22/2020
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