Provider Demographics
NPI:1588668198
Name:ABERJONA NURSING CENTER, INC
Entity Type:Organization
Organization Name:ABERJONA NURSING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DRISCOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-994-2114
Mailing Address - Street 1:184 SWANTON ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1921
Mailing Address - Country:US
Mailing Address - Phone:781-729-9370
Mailing Address - Fax:781-729-3817
Practice Address - Street 1:184 SWANTON ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1921
Practice Address - Country:US
Practice Address - Phone:781-729-9370
Practice Address - Fax:781-729-3817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0848314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0911062Medicaid
MA2222543301OtherBLUE CROSS BLUE SHIELD
MA903181OtherHARVARD PILGRIM HEALTH
MA612047OtherTUFTS/SECURE HORIZONS
MA=========OtherAETNA/US HEALTHCARE
MA=========OtherFALLON HEALTH CARE
MA612047OtherTUFTS/SECURE HORIZONS