NPI 1902322092 · live from the CMS NPI Registry
1102 Washington Street Operator LLC
Skilled Nursing Facility in Braintree, MA. National Provider Identifier 1902322092, active.
NPI record
| NPI | 1902322092 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 1102 Washington St, Braintree, MA 02184 |
| Practice phone | 781-848-3100 |
| Enumerated | August 21, 2017 |
| Last updated | July 21, 2022 |
| Authorized official | William Stephan, Cfo |
| Other names | Braintree Manor Healthcare |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.