Provider Demographics
NPI:1669682019
Name:JOHN SCOTT HOUSE REHABILITATION & NURSING CENTER
Entity type:Organization
Organization Name:JOHN SCOTT HOUSE REHABILITATION & NURSING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:NOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:781-843-1860
Mailing Address - Street 1:233 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4840
Mailing Address - Country:US
Mailing Address - Phone:781-843-1860
Mailing Address - Fax:781-843-8834
Practice Address - Street 1:233 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4840
Practice Address - Country:US
Practice Address - Phone:781-843-1860
Practice Address - Fax:781-843-8834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0903507Medicaid
MA0903507Medicaid
MA225054Medicare ID - Type Unspecified