Provider Demographics
NPI:1942286158
Name:SEVEN HILLS EXTENDED CARE AT GROTON, INC.
Entity Type:Organization
Organization Name:SEVEN HILLS EXTENDED CARE AT GROTON, INC.
Other - Org Name:SEVEN HILLS AT GROTON, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:E
Authorized Official - Last Name:JAREK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-448-3388
Mailing Address - Street 1:22 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-1284
Mailing Address - Country:US
Mailing Address - Phone:978-448-3388
Mailing Address - Fax:978-448-9695
Practice Address - Street 1:22 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-1284
Practice Address - Country:US
Practice Address - Phone:978-448-3388
Practice Address - Fax:978-448-9695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-20
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA07913140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0929131Medicaid
MA0931004Medicaid