CHARLTON MANOR REST HOME INC (NPI# 1962528968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962528968 |
| Entity Type | Organization |
| Organization Name | CHARLTON MANOR REST HOME INC |
| Practice Address |
12 Town Farm Rd Charlton MA 01507-1556 |
| Mailing Address |
Po Box 216 Rochdale MA 01542-0216 |
| Practice Telephone | 5082485136 |
| Mailing Telephone | 5082485136 |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CAROLYN IANDOLI (ADMINISTRATOR) |
| Authorized Official Telephone | 5082485136 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311Z00000X | Custodial Care Facility | 1059 | MA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | PROVIDER NUMBER | 5507618 | 01 |
| Street Address |
12 TOWN FARM RD |
| City | CHARLTON |
| State | MA |
| Zip Code | 01507-1556 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932419777 | Charlton Manor Rest Home LLC | Nursing Facility/Intermediate Care Facility | 12 Town Farm Rd, Charlton, MA 01507-1556 | 2010-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477179653 | Lissette Hernandez | Counselor | 159 C Worcester Road, Charlton, MA 01507 | 2020-06-23 |
| 1841657426 | Renee M Gomez-chlebica Od LLC | Optometrist | 109-6 Masonic Home Rd., Charlton, MA 01507 | 2016-01-27 |
| 1467728725 | Rebecca Bullock | Occupational Therapist | 11 Sunset Drive, Charlton, MA 01507 | 2012-03-30 |
| 1326347139 | Michelle Beshire | Pharmacist | 188 Center Depot Rd, Charlton, MA 01507 | 2011-03-18 |
| 1063710762 | Daniel R Tetreault | Specialist/Technologist | 70 Hanson Road, Charlton, MA 01507 | 2011-03-03 |
| 1508901828 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 142 Worcester Rd, Charlton, MA 01507 | 2007-02-21 |
| 1780727743 | Peter Maly | Technician/Technologist | 109-6 Masonic Home Road, Charlton, MA 01507 | 2007-02-15 |
| 1083680128 | Mary-elise Smith | Emergency Medicine | 10 North Main Street, Charlton, MA 01507 | 2006-02-28 |
| 1932183241 | Steven V Vachula II | Optometrist | 20 Southbridge Rd, Charlton, MA 01507 | 2005-11-30 |
| 1154304228 | Teddi Bachawaty | Obstetrics & Gynecology | 9 Trolley Crossing Rd, Charlton, MA 01507 | 2005-11-22 |
| Find all providers in zip 01507 | ||||
| Taxonomy Code | 311Z00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. |
| Notes: Source: Paraphrased from Section 3159 A3 of the Medicare Intermediary Manual. |
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| 1295169977 | Boston Nutrition Care | Custodial Care Facility | 51 Neponset Ave, Dorchester, MA 02122-3321 | 2013-08-29 |
| 1912203217 | Goddard/homestead | Custodial Care Facility | 10 Homestead Avenue, Worcester, MA 01610 | 2011-02-03 |
| 1871817569 | Horn Home for Aged | Custodial Care Facility | 98 Smith St, Lowell, MA 01851-2614 | 2010-03-24 |
| 1114166188 | Oosterman Rest Home Inc. | Custodial Care Facility | 93 Laurel St, Melrose, MA 02176-4044 | 2009-02-13 |
| 1124267299 | Oosterman's Melrose Rest Home Inc. | Custodial Care Facility | 101 Laurel St, Melrose, MA 02176-4044 | 2009-02-13 |
| 1265608236 | Sophia Snow House, Inc. | Custodial Care Facility | 1215 Centre St, West Roxbury, MA 02132-7701 | 2008-04-30 |
| 1851579031 | Ez Home Care | Custodial Care Facility | 85 Alexander St, Dorchester, MA 02125-2727 | 2008-02-09 |
| 1891989000 | Davenport Memorial Foundation | Custodial Care Facility | 70 Salem St, Malden, MA 02148-5208 | 2007-08-30 |
| 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.