Provider Demographics
NPI:1497824544
Name:ST. JULIE BILLIART RESIDENTIAL CARE CENTER
Entity Type:Organization
Organization Name:ST. JULIE BILLIART RESIDENTIAL CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:SISTER OF NOTRE DAME
Authorized Official - Phone:978-380-1372
Mailing Address - Street 1:30 JEFFREYS NECK RD
Mailing Address - Street 2:
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-1308
Mailing Address - Country:US
Mailing Address - Phone:978-356-4381
Mailing Address - Fax:978-356-1380
Practice Address - Street 1:30 JEFFREYS NECK RD
Practice Address - Street 2:
Practice Address - City:IPSWICH
Practice Address - State:MA
Practice Address - Zip Code:01938-1308
Practice Address - Country:US
Practice Address - Phone:978-356-4381
Practice Address - Fax:978-356-1380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1B9G313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5508878Medicaid