- Enrollment id
- O20111217000006
- Enrollment state
- MA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1063419521
- Multiple npi flag
- N
- Ccn
- 225752
- Associate id
- 3375718570
- Organization name
- LONG TERM CENTERS OF WRENTHAM, INC
- Doing business as name
- SERENITY HILL NURSING & REHABILITATION CENTER
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- SERENITY HILL NURSING CENTER
- Address line 1
- 655 DEDHAM ST
- City
- WRENTHAM
- State
- MA
- Zip code
- 020931135