Provider Demographics
NPI:1073509378
Name:METRO HEALTH FOUNDATION OF MASSACHUSETTS, INC
Entity Type:Organization
Organization Name:METRO HEALTH FOUNDATION OF MASSACHUSETTS, INC
Other - Org Name:ALDEN COURT NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-717-0102
Mailing Address - Street 1:389 ALDEN ROAD
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-4451
Mailing Address - Country:US
Mailing Address - Phone:508-991-8600
Mailing Address - Fax:508-992-3708
Practice Address - Street 1:389 ALDEN ROAD
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-4451
Practice Address - Country:US
Practice Address - Phone:508-991-8600
Practice Address - Fax:508-992-3708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0912314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110026525CMedicaid
MA0929271Medicaid
MA110026525CMedicaid