Provider Demographics
NPI:1558343822
Name:SWANSEA REST HOME INC
Entity Type:Organization
Organization Name:SWANSEA REST HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARION
Authorized Official - Middle Name:G
Authorized Official - Last Name:ALBRITTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-678-8661
Mailing Address - Street 1:115 WILBUR AVE
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-2619
Mailing Address - Country:US
Mailing Address - Phone:508-678-8661
Mailing Address - Fax:508-677-4926
Practice Address - Street 1:115 WILBUR AVE
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-2619
Practice Address - Country:US
Practice Address - Phone:508-678-8661
Practice Address - Fax:508-677-4926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5501997Medicaid