- Enrollment id
- O20230708000224
- Enrollment state
- NH
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1215654231
- Multiple npi flag
- N
- Ccn
- 305086
- Associate id
- 0042679094
- Organization name
- BEDFORD SNF OPCO LLC
- Doing business as name
- BEDFORD NURSING AND REHABILITATION CENTER
- Incorporation date
- 2022-09-20
- Incorporation state
- NH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- BEDFORD NURSING & REHABILITATION CENTER
- Address line 1
- 480 DONALD ST
- City
- BEDFORD
- State
- NH
- Zip code
- 031105945