SRC BREWSTER ALF, LLC (NPI# 1669846358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669846358 |
| Entity Type | Organization |
| Organization Name | SRC BREWSTER ALF, LLC |
| Practice Address |
855 Harwich Rd Brewster MA 02631-5223 |
| Mailing Address |
63 Kendrick St Needham MA 02494-2708 |
| Practice Telephone | 5088963252 |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2015-11-19 |
| Authorized Official Name | TAMILYN LEVIN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 7817079510 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | SRC BREWSTER ALF, LLC | 63 Kendrick Street, Needham, MA 02494 |
| Street Address |
855 HARWICH RD |
| City | BREWSTER |
| State | MA |
| Zip Code | 02631-5223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437322815 | Epoch of Brewster, LLC | Assisted Living Facility | 855 Harwich Rd, Brewster, MA 02631-5223 | 2008-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548813850 | Pleasant Bay of Brewster Rehab Center LLC | Skilled Nursing Facility | 383 South Orleans Road, Brewster, MA 02631 | 2019-07-17 |
| 1669972790 | Julie Lynne Mollica | Social Worker | 456 Flax Pond Road, Brewster Treatment Program, Old Colony Ymca, Brewster, MA 02631 | 2018-02-15 |
| 1295244168 | Michele Louise Oconnor | Occupational Therapist | 1721 Long Pond Road, Brewster, MA 02631 | 2017-09-23 |
| 1356799902 | Katherine Drach Reilly | Behavioral Analyst | 63 Brook Trail Rd, Brewster, MA 02631 | 2016-05-24 |
| 1407214901 | Md Visits LLC | Emergency Medicine | 162 Highland Moors Dr., Brewster, MA 02631 | 2016-01-29 |
| 1720350390 | Kevin Whelley | Counselor | 21 Cross Street, Brewster, MA 02631 | 2012-01-30 |
| 1518238609 | Pleasant Bay Health and Wellness Center LLC | Physical Therapist | 64 Woodlands Way, Brewster, MA 02631 | 2012-01-20 |
| 1184740953 | Jacs Ops IIi, Inc | Assisted Living Facility | 855 Harwich Road, Brewster, MA 02631 | 2007-03-22 |
| 1184763997 | Beverly Ann Biondi | Physical Therapist | 84 Underpass Rd, Brewster, MA 02631 | 2007-02-06 |
| 1679646384 | Paul James Tausek | Social Worker | 25 Breakwater Rd, Brewster, MA 02631 | 2006-11-17 |
| Find all providers in zip 02631 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093958126 | Pleasant Bay Health and Living Centers, LLC | Assisted Living Facility | 120 Woodlands Way, Brewster, MA 02631-5259 | 2009-04-20 |
| 1437322815 | Epoch of Brewster, LLC | Assisted Living Facility | 855 Harwich Rd, Brewster, MA 02631-5223 | 2008-04-08 |
| 1184740953 | Jacs Ops IIi, Inc | Assisted Living Facility | 855 Harwich Road, Brewster, MA 02631 | 2007-03-22 |
| 1871135970 | Pleasant Bay of Brewster Assisted Living LLC | Assisted Living Facility | 120 Woodlands Way, Brewster, MA 02631 | 2019-10-10 |
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|---|---|---|---|---|
| 1396370649 | Roderick Family LLC | Assisted Living Facility | 46 Lincoln St, Winthrop, MA 02152-2151 | 2020-03-06 |
| 1093355083 | Naafay, LLC | Assisted Living Facility | 265 Bear Hill Rd, North Andover, MA 01845-2115 | 2020-01-08 |
| 1184284705 | Erlin Manor Assisted Living, Inc. | Assisted Living Facility | 10b Erlin Ter, Tewksbury, MA 01876-2685 | 2019-06-17 |
| 1811465974 | Shi-iii Wrentham LLC | Assisted Living Facility | 30 Ledgeview Way, Attn: Executive Director Or Dba, Wrentham, MA 02093 | 2018-11-07 |
| 1023516465 | D'youville Leadership Solutions | Assisted Living Facility | 1085 Varnum Ave, Lowell, MA 01854-1133 | 2018-01-31 |
| 1457868622 | B-x Worcester LLC | Assisted Living Facility | 340 May St, Worcester, MA 01602-1800 | 2018-01-09 |
| 1841707098 | B-x Agawam LLC | Assisted Living Facility | 153 Cardinal Dr, Agawam, MA 01001-2182 | 2018-01-09 |
| 1811404544 | B-xi Operations Holding Company LLC | Assisted Living Facility | Benchmark At Robbins Brook, 10 Devon Drive, Acton, MA 01720 | 2018-01-03 |
| 1558876060 | Belchertown Heights Alf Lp | Assisted Living Facility | 99 Front Street, Belchertown, MA 01007 | 2017-12-06 |
| 1265962658 | Wincare LLC | Assisted Living Facility | 704 Beaver St, Waltham, MA 02452-5648 | 2017-06-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.