Provider Demographics
NPI:1275561383
Name:NEW ENGLAND LONG TERM CARE, INC.
Entity Type:Organization
Organization Name:NEW ENGLAND LONG TERM CARE, INC.
Other - Org Name:NEW ENGLAND PEDIATRIC CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:O'GORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:978-667-5123
Mailing Address - Street 1:78 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:N BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01862-1034
Mailing Address - Country:US
Mailing Address - Phone:978-667-5123
Mailing Address - Fax:978-663-5154
Practice Address - Street 1:78 BOSTON RD
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01862-1034
Practice Address - Country:US
Practice Address - Phone:978-667-5123
Practice Address - Fax:978-663-5154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0756314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0930377Medicaid
551849OtherAETNA-HMO
MA2222599910OtherBC/BS - OUTPATIENT REHAB
710039OtherTUFTS
MA2222599901OtherBC/BS - MEDICARE BLUE
MA2222599902OtherBC/BS-IND/PPO/VENT
0020348OtherNEIGHBORHOOD HEALTH PLAN
904729OtherHARVARD PILGRIM
551849OtherAETNA-HMO
MA2222599902OtherBC/BS-IND/PPO/VENT
=========OtherAETNA-NONHMO