Provider Demographics
NPI:1629662275
Name:LEDGEWOOD SNF LLC
Entity Type:Organization
Organization Name:LEDGEWOOD SNF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DIFRANCESCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-501-9761
Mailing Address - Street 1:350 GRANITE ST STE 2203
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4963
Mailing Address - Country:US
Mailing Address - Phone:781-501-9761
Mailing Address - Fax:781-871-3986
Practice Address - Street 1:87 HERRICK ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-2773
Practice Address - Country:US
Practice Address - Phone:978-921-1392
Practice Address - Fax:978-921-7140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility