Provider Demographics
NPI:1851666721
Name:WELLESLEY HEALTHCARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:WELLESLEY HEALTHCARE SOLUTIONS LLC
Other - Org Name:JESMOND NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TARIQ
Authorized Official - Middle Name:
Authorized Official - Last Name:QURESHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-581-0420
Mailing Address - Street 1:271 NAHANT RD
Mailing Address - Street 2:
Mailing Address - City:NAHANT
Mailing Address - State:MA
Mailing Address - Zip Code:01908-1341
Mailing Address - Country:US
Mailing Address - Phone:781-581-0420
Mailing Address - Fax:
Practice Address - Street 1:271 NAHANT RD
Practice Address - Street 2:
Practice Address - City:NAHANT
Practice Address - State:MA
Practice Address - Zip Code:01908-1341
Practice Address - Country:US
Practice Address - Phone:781-581-0420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-12
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA225471OtherMEDICARE PTAN
MA110092999AMedicaid