- Enrollment id
- O20170817004039
- Enrollment state
- MA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1417486713
- Multiple npi flag
- N
- Ccn
- 225343
- Associate id
- 5597037010
- Organization name
- 460 WASHINGTON STREET OPERATOR LLC
- Doing business as name
- NORWOOD HEALTHCARE
- Incorporation date
- 2017-04-06
- Incorporation state
- MA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- NORWOOD HEALTHCARE
- Affiliation entity name
- NEXT STEP HEALTHCARE
- Affiliation entity id
- 371
- Address line 1
- 460 WASHINGTON ST
- City
- NORWOOD
- State
- MA
- Zip code
- 020622312