Organization
WABAN HEALTH & REHABILATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEAN DURSO (CFO)
(617) 332-8481
Entity
Organization
Contact information
Practice address
20 KINMONTH RD, NEWTON, MA 02468-1503
(617) 332-8481
(617) 332-8959
Mailing address
20 KINMONTH RD, NEWTON, MA 02468-1503
(617) 332-8481
(617) 332-8959
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0387
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0924512
—
MA
01
—
0Q00490001
BC/BS, MEDEX PROVIDER ID
MA
01
—
667864
TUFTS PROVIDER ID
MA
01
—
908337
HAVARD PILGRIM ID
MA
Enumeration date
07/21/2005
Last updated
02/02/2012
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