Provider Demographics
NPI:1376517714
Name:HANCOCK PARK LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:HANCOCK PARK LIMITED PARTNERSHIP
Other - Org Name:HANCOCK PARK REHABILITATION AND NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-878-6700
Mailing Address - Street 1:52 ACCORD PARK DR
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1628
Mailing Address - Country:US
Mailing Address - Phone:781-878-6700
Mailing Address - Fax:781-878-9807
Practice Address - Street 1:164 PARKINGWAY ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5020
Practice Address - Country:US
Practice Address - Phone:617-773-4222
Practice Address - Fax:617-773-1115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAOFEG314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0012772OtherNIEGHBORHOOD HEALTH - HMO
MA0923257Medicaid
MA2222571801OtherBLUE CROSS - HMO
MA805464OtherTUFTS HEALTH - HMO
MA905759OtherHARVARD PILGRIM - HMO
MA225718Medicare Oscar/Certification