Provider Demographics
NPI:1790317550
Name:VERO HEALTH XVII, LLC
Entity Type:Organization
Organization Name:VERO HEALTH XVII, LLC
Other - Org Name:VERO HEALTH & REHAB OF REVERE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EAMONN
Authorized Official - Middle Name:D
Authorized Official - Last Name:REILLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-992-0500
Mailing Address - Street 1:10500 LITTLE PATUXENT PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3522
Mailing Address - Country:US
Mailing Address - Phone:410-992-0500
Mailing Address - Fax:443-539-7657
Practice Address - Street 1:133 SALEM ST
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-1114
Practice Address - Country:US
Practice Address - Phone:781-322-4861
Practice Address - Fax:781-324-1191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility