Provider Demographics
NPI:1093856031
Name:BARRY L. PRICE REHABILITATION CENTER, INC.
Entity Type:Organization
Organization Name:BARRY L. PRICE REHABILITATION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGNOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-244-0065
Mailing Address - Street 1:38 BORDER ST
Mailing Address - Street 2:
Mailing Address - City:WEST NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02465-2006
Mailing Address - Country:US
Mailing Address - Phone:617-332-7477
Mailing Address - Fax:617-332-9218
Practice Address - Street 1:38 BORDER ST
Practice Address - Street 2:
Practice Address - City:WEST NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02465-2006
Practice Address - Country:US
Practice Address - Phone:617-332-7477
Practice Address - Fax:617-332-9218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1311166Medicaid
MA1311662Medicaid