Provider Demographics
NPI:1336245703
Name:ASHMONT HILL, LLC
Entity Type:Organization
Organization Name:ASHMONT HILL, LLC
Other - Org Name:ST JOSEPH REHAB & NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:BARANELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-372-4004
Mailing Address - Street 1:321 CENTRE STREET
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02122
Mailing Address - Country:US
Mailing Address - Phone:617-825-6320
Mailing Address - Fax:617-825-7410
Practice Address - Street 1:321 CENTRE STREET
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02122
Practice Address - Country:US
Practice Address - Phone:617-825-6320
Practice Address - Fax:617-825-7410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0920314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0928895Medicaid
MA0928895Medicaid