Provider Demographics
NPI:1356467013
Name:NEVILLE ASSISTED LLP
Entity Type:Organization
Organization Name:NEVILLE ASSISTED LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCWILLIAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-497-8700
Mailing Address - Street 1:650 CONCORD AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1129
Mailing Address - Country:US
Mailing Address - Phone:617-497-8700
Mailing Address - Fax:
Practice Address - Street 1:650 CONCORD AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-1129
Practice Address - Country:US
Practice Address - Phone:617-497-8700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1905333310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1905333Medicaid