Cpl (glen Ridge) Llc, NPI 1760479349
Skilled Nursing Facility in Medford, MA, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1760479349
NPI Entity Type Organization
Provider Name Cpl (glen Ridge) Llc
Doing Business As
Subpart of Organization New Jersey Subacute Llc
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Provider Location Address 120 Murray Street, Medford, MA, US
Provider Mailing Address 538 Presont Avenue, Suite 270, Meriden, CT, US, 064504851
Is Sole Proprietor? No
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Organization Official

Official Name MR. Carole M Scillia
Official Position LLC MANAGER
Phone 203-608-6100

Primary Taxonomy

Taxonomy Code

314000000X

Taxonomy Name Skilled Nursing Facility
Classification

Skilled Nursing Facility

Group

Nursing & Custodial Care Facilities

License No. 0919
License State MA
Description (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Other Organization Name

Glen Ridge Nursing Care Center
Doing Business As

Business Address

Cpl (glen Ridge) Llc
120 Murray Street

Medford, MA, US

Phone: 781-391-0800
Fax: 781-391-9127

Mailing Address

Cpl (glen Ridge) Llc
538 Presont Avenue
Suite 270
Meriden, CT, US
ZIP 064504851
Phone: 203-608-6100
Fax: 203-639-3574

Secondary Taxonomies

Taxonomy Code Group Classification License No. State Primary?

314000000X

Nursing & Custodial Care Facilities

Skilled Nursing Facility

No

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
22225523 MA BLUE CROSS BLUE SHIELD 01
907769 MA HARVARD PILGRIM 01
982256 MA TUFTS HMO 01
7100014 MA EVERCARE 01
0940054 MA MEDICAID 05

Other Providers in MA, US

NPI Name Taxonomy Address

1528553229

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DR. DPM Steeve Yamadjako

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AGNP-C Kaitlyn Manlove

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1538821368

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1497417315

BCBA Christina Marie Gravina

Individual

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303 Wyman St Ste 300

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1295320059

PMHNP-BC Feyisetan Rebecca Idowu

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Quincy, MA

1891416186

FNP-BC Taylor Elise Stuart

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1780307918

Aseda Suboxone Clinic Llc

Organization

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MD Thy Ngoc Minh Dang

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Internal Medicine Physician

77 Warren St

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1871225904

PA-C James Whitney Diamantopoulos

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Physician Assistant

43 Hobart St

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1881340982

Sarah Lee Dmd Llc

Organization

General Practice Dentistry

121 Charles St S

Boston, MA

1790126746

DR. D.M.D Sarah Bohyun Lee

Individual

Dentist

121 Charles St S

Boston, MA

1154604833

LICSW Jeff H Butts

Individual

Clinical Social Worker

1180 Beacon St Ste Ll-b

Brookline, MA

1396460762

Duncan Hearing Falmouth Llc

Organization

Specialist

82 Wendell Ave Ste 100

Pittsfield, MA

1205551678

Gabriella Guillette

Individual

Social Worker

115 Mill St

Belmont, MA

1689399057

Kristen Fleck

Individual

Pharmacist

675 County St

Taunton, MA

1669031092

Yang Li

Individual

Family Medicine Physician

11 Nevins St Ste 505

Brighton, MA

1427773894

Monique Barrett

Individual

Licensed Practical Nurse

58 Woodside Rd

Spencer, MA

1033690268

Ellen Beth Wittlin

Individual

Clinical Social Worker

247 Station Dr Ste Nw1

Westwood, MA

1366167728

MISS WHNP Megan Eileen Fickes

Individual

Psychiatric/Mental Health Registered Nurse

10 Carematrix Dr

Dedham, MA

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