Provider Demographics
NPI:1013904218
Name:NORWELL KNOLL INC
Entity Type:Organization
Organization Name:NORWELL KNOLL INC
Other - Org Name:NORWELL KNOLL REHABILITATION & NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES ADM
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:GEANY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-659-4901
Mailing Address - Street 1:329 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1794
Mailing Address - Country:US
Mailing Address - Phone:781-659-4901
Mailing Address - Fax:781-659-0065
Practice Address - Street 1:329 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1794
Practice Address - Country:US
Practice Address - Phone:781-659-4901
Practice Address - Fax:781-659-0065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-03
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0904759Medicaid
MA0904759Medicaid
MA0565800001Medicare NSC