Basic Information
| Provider Information | |||||||||
| NPI: | 1619385531 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BEDFORD NURSING & REHAB SERVICES, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | BEDFORD NURSING & REHABILITATION CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 480 DONALD ST | ||||||||
| Address2: | |||||||||
| City: | BEDFORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031105945 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036274147 | ||||||||
| FaxNumber: | 6036443716 | ||||||||
| Practice Location | |||||||||
| Address1: | 480 DONALD ST | ||||||||
| Address2: | |||||||||
| City: | BEDFORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031105945 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036274147 | ||||||||
| FaxNumber: | 6036443716 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2014 | ||||||||
| LastUpdateDate: | 07/23/2014 | ||||||||
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| AuthorizedOfficialLastName: | TURCOTTE | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | MICHAEL | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6036224323 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | NH | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.