Provider Demographics
NPI:1144599028
Name:GLENMEADOW, INC.
Entity Type:Organization
Organization Name:GLENMEADOW, INC.
Other - Org Name:CHESTNUT KNOWLL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:LESLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-567-7800
Mailing Address - Street 1:24 TABOR XING
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1779
Mailing Address - Country:US
Mailing Address - Phone:413-567-7800
Mailing Address - Fax:413-567-7945
Practice Address - Street 1:24 TABOR XING
Practice Address - Street 2:
Practice Address - City:LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01106-1779
Practice Address - Country:US
Practice Address - Phone:413-567-7800
Practice Address - Fax:413-567-7945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No253Z00000XAgenciesIn Home Supportive Care