Basic Information
Provider Information
NPI: 1366495855
EntityType: 2
ReplacementNPI:  
OrganizationName: SNH SE TENANT TRS, INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: THE GARDENS OF SCOTTSDALE
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 255 WASHINGTON STREET
Address2: 2 NEWTON PLACE
City: NEWTON
State: MA
PostalCode: 02458
CountryCode: US
TelephoneNumber: 7038540823
FaxNumber: 7038450164
Practice Location
Address1: 6001 E THOMAS RD
Address2:  
City: SCOTTSDALE
State: AZ
PostalCode: 852517511
CountryCode: US
TelephoneNumber: 4809412222
FaxNumber: 4809412741
Other Information
ProviderEnumerationDate: 05/18/2006
LastUpdateDate: 10/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MINTZER
AuthorizedOfficialFirstName: JENNIFER
AuthorizedOfficialMiddleName: F.
AuthorizedOfficialTitleorPosition: PRESIDENT & CHIEF OPERATING OFFICER
AuthorizedOfficialTelephone: 6177968350
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: SNH SE TENANT TRS, INC
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
311500000X  N Nursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center) 
314000000XNCI422AZN Nursing & Custodial Care FacilitiesSkilled Nursing Facility 
310400000X  Y Nursing & Custodial Care FacilitiesAssisted Living Facility 

No ID Information.


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