Provider Demographics
NPI:1376627331
Name:PEABODY MANAGEMENT SYSTEMS INC
Entity Type:Organization
Organization Name:PEABODY MANAGEMENT SYSTEMS INC
Other - Org Name:PILGRIM REHABILITATION & SKILLED NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-447-2996
Mailing Address - Street 1:96 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-3907
Mailing Address - Country:US
Mailing Address - Phone:978-532-0303
Mailing Address - Fax:978-531-6112
Practice Address - Street 1:96 FOREST ST
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-3907
Practice Address - Country:US
Practice Address - Phone:978-532-0303
Practice Address - Fax:978-531-6112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0295314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0919977Medicaid
MA0919977Medicaid
MA=========OtherECARE EVERCARE
MA0919977Medicaid
MA0649700001Medicare NSC
MA=========OtherESPN ELDR SVCPLAN N.SHORE