Provider Demographics
NPI:1093744286
Name:METRO WEST REHAB CORP
Entity Type:Organization
Organization Name:METRO WEST REHAB CORP
Other - Org Name:WHITTIER REHABILITATION HOSPITAL-WESTBOROUGH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:J
Authorized Official - Last Name:ARCIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-556-5858
Mailing Address - Street 1:25 RAILROAD SQ
Mailing Address - Street 2:SUITE 503
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832-5721
Mailing Address - Country:US
Mailing Address - Phone:978-556-5907
Mailing Address - Fax:978-521-8818
Practice Address - Street 1:150 FLANDERS RD
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1017
Practice Address - Country:US
Practice Address - Phone:508-871-2000
Practice Address - Fax:508-871-2048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA104282E00000X, 283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
No282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
S011971OtherCHAMPUS
413150OtherCIGNA/HEALTHSOURCE
MA2222303310OtherBLUE CROSS (OUTPATIENT)
873262OtherAETNA/US HEALTHCARE
5080305OtherEVERCARE
MA0019446OtherNEIGHBORHOOD HEALTH PLAN
MA110027433AMedicaid
MA1103237Medicaid
MA613991OtherTUFTS HEALTH PLAN (OP)
MA110027433BMedicaid
MA1211854Medicaid
MA2222303301OtherBLUE CROSS (IP)
MA2222303302OtherBLUE CROSS IP LEV 2
MA613898OtherTUFTS HEALTH PLAN (IP)
MA903265OtherHARVARD PILGRIM
MA613898OtherTUFTS HEALTH PLAN (IP)