Provider Demographics
NPI:1801832274
Name:NEW ENGLAND LONG TERM CARE, INC.
Entity Type:Organization
Organization Name:NEW ENGLAND LONG TERM CARE, INC.
Other - Org Name:NEW ENGLAND PEDIATRIC CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZERALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-667-5123
Mailing Address - Street 1:78 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:N BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01862-1034
Mailing Address - Country:US
Mailing Address - Phone:978-667-5123
Mailing Address - Fax:978-663-5154
Practice Address - Street 1:78 BOSTON RD
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01862-1034
Practice Address - Country:US
Practice Address - Phone:978-667-5123
Practice Address - Fax:978-663-5154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251J00000X, 311Z00000X, 313M00000X, 3140N1450X, 315P00000X
MA0756314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No251J00000XAgenciesNursing Care
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
No315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
0020348OtherNEIGHBORHOOD HEALTH PLAN
904729OtherHARVARD PILGRIM
MA2222599901OtherBC/BS - MEDICARE BLUE
MA2222599902OtherBC.BS-IND/PPO/VENT
551849OtherAETNA-HMO
710039OtherTUFTS
MA0924164Medicaid
MA2222599910OtherBC.BS - OUTPATIENT REHAB
904729OtherHARVARD PILGRIM
=========OtherGREAT-WEST HEALTHCARE
710039OtherTUFTS