Basic Information
| Provider Information | |||||||||
| NPI: | 1508386897 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEB OPERATOR LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 635 DUQUESNE BLVD | ||||||||
| Address2: | |||||||||
| City: | BRICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087235073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7329031958 | ||||||||
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| Practice Location | |||||||||
| Address1: | 70 FULTON ST | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021091402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177269700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2017 | ||||||||
| LastUpdateDate: | 06/27/2017 | ||||||||
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| AuthorizedOfficialLastName: | POSEN | ||||||||
| AuthorizedOfficialFirstName: | MINDEE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CONTROLLER | ||||||||
| AuthorizedOfficialTelephone: | 7329031958 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CPA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | MA | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.