Provider Demographics
NPI:1851357495
Name:SNH SE BARRINGTON BOYNTON TENANT LLC
Entity type:Organization
Organization Name:SNH SE BARRINGTON BOYNTON TENANT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:BOLOTTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-796-8387
Mailing Address - Street 1:255 WASHINGTON ST STE 230
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-1644
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1425 CONGRESS AVENUE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-6381
Practice Address - Country:US
Practice Address - Phone:561-369-7919
Practice Address - Fax:561-369-3413
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SNH SE BARRINGTON BOYNTON TENANT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-22
Last Update Date:2025-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
310400000X, 311500000X
FLSNF1616096314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105850Medicare Oscar/Certification