Provider Demographics
NPI:1124006481
Name:LONG TERM CENTERS OF NEW ENGLAND INC
Entity Type:Organization
Organization Name:LONG TERM CENTERS OF NEW ENGLAND INC
Other - Org Name:MILL POND REST HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-881-1360
Mailing Address - Street 1:84 MYRTLE ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-1113
Mailing Address - Country:US
Mailing Address - Phone:508-881-1360
Mailing Address - Fax:508-881-0012
Practice Address - Street 1:84 MYRTLE ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MA
Practice Address - Zip Code:01721-1113
Practice Address - Country:US
Practice Address - Phone:508-881-1360
Practice Address - Fax:508-881-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1012311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5506913Medicaid