Provider Demographics
NPI:1992707178
Name:YOUVILLE HOSPITAL & REHABILITATION CENTER
Entity type:Organization
Organization Name:YOUVILLE HOSPITAL & REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:617-876-4344
Mailing Address - Street 1:1575 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-4308
Mailing Address - Country:US
Mailing Address - Phone:617-876-4344
Mailing Address - Fax:617-234-7913
Practice Address - Street 1:1575 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4308
Practice Address - Country:US
Practice Address - Phone:617-876-4344
Practice Address - Fax:617-234-7913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA900582OtherHARVARD COMMUNITY HEALTH
MACA7049OtherMEDICARE RAILROAD
MA2222200002OtherREHABILITATION INPATIENT
NH30014212Medicaid
RI0222000Medicaid
MA1103105Medicaid
MA905169OtherTUFTS HEALTH PLAN INPT NO
MA996006OtherNETWORK HEALTH
NH30014212Medicaid
MA2222200002OtherREHABILITATION INPATIENT