Provider Demographics
NPI:1255478962
Name:JEWISH REHABILITATION CENTER
Entity Type:Organization
Organization Name:JEWISH REHABILITATION CENTER
Other - Org Name:SHAPIRO RUDOLPH ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTERRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-471-5100
Mailing Address - Street 1:240 LYNNFIELD ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-5055
Mailing Address - Country:US
Mailing Address - Phone:978-471-5100
Mailing Address - Fax:978-471-5508
Practice Address - Street 1:240 LYNNFIELD ST
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-5055
Practice Address - Country:US
Practice Address - Phone:978-471-5100
Practice Address - Fax:978-471-5508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA0600X
MA0776314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1948555Medicaid