Provider Demographics
NPI:1679281687
Name:BRAINTREE OPCO LLC
Entity Type:Organization
Organization Name:BRAINTREE OPCO LLC
Other - Org Name:ROYAL BRAINTREE NURSING & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:ELI
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-645-0150
Mailing Address - Street 1:277 ROUTE 70 STE 205
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-1569
Mailing Address - Country:US
Mailing Address - Phone:929-645-0150
Mailing Address - Fax:
Practice Address - Street 1:95 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4301
Practice Address - Country:US
Practice Address - Phone:781-848-0596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility