Provider Demographics
NPI:1114048592
Name:FS COMMONWEALTH LLC
Entity Type:Organization
Organization Name:FS COMMONWEALTH LLC
Other - Org Name:NEW ENGLAND REHABILITATION HOSPITAL, NERH
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:FELEGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-935-5050
Mailing Address - Street 1:2 REHABILITATION WAY
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-6003
Mailing Address - Country:US
Mailing Address - Phone:781-935-5050
Mailing Address - Fax:781-935-6756
Practice Address - Street 1:17 WARREN AVE
Practice Address - Street 2:NERH WARREN HOUSE
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-4936
Practice Address - Country:US
Practice Address - Phone:781-937-3544
Practice Address - Fax:781-937-7621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2329283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1906526Medicaid