Provider Demographics
NPI:1104038199
Name:NORTH COUNTRY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:NORTH COUNTRY ASSOCIATES, INC.
Other - Org Name:ROSEWOOD MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:508-432-0135
Mailing Address - Street 1:671 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645
Mailing Address - Country:US
Mailing Address - Phone:508-432-0135
Mailing Address - Fax:508-430-2052
Practice Address - Street 1:671 MAIN STREET
Practice Address - Street 2:
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645
Practice Address - Country:US
Practice Address - Phone:508-432-0135
Practice Address - Fax:508-430-2052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1097311ZA0620X, 313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Not Answered313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5507405OtherDEPARTMENT OF PUBLIC HEAL