PROSPECT HOUSE
NPI 1962625392
Assisted Living Facility in Revere, MA

Active since April 11, 2007
420 RESERVOIR AVE, REVERE, MA 02151(781) 853-0005 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Prospect House NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROSPECT HOUSE (NPI 1962625392) is a healthcare organization registered as an assisted living facility in Revere, Massachusetts and active in the NPI registry since April 2007. The organization lists Shawn Bertram, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1962625392
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NamePROSPECT HOUSE
Location Address420 RESERVOIR AVERevere, MA 02151-5819
Mailing Address420 Reservoir AveRevere, MA 02151-5819
Organization SubpartNo
Authorized OfficialShawn BertramExecutive Director · (781) 853-0005
Enumeration DateApril 11, 2007
Last NPPES UpdateAugust 22, 2020
NPI 1962625392 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

420 RESERVOIR AVE, Revere, MA 02151

Other Identifiers 1

Medicaid1905139MA

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prospect House's NPI number?

The NPI number for Prospect House is 1962625392. It was assigned to this organization in the NPPES registry on April 11, 2007.

Where is Prospect House located?

Prospect House is located at 420 Reservoir Ave, Revere, MA 02151. The listed phone number is (781) 853-0005.

What is Prospect House's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Prospect House was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.