Provider Demographics
NPI:1164433520
Name:ORCHARD COVE, INC.
Entity Type:Organization
Organization Name:ORCHARD COVE, INC.
Other - Org Name:COMMONS RESIDENCE AT ORCHARD COVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF HEALTHCARE
Authorized Official - Prefix:MS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HEGARTY
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, NHA
Authorized Official - Phone:781-821-3120
Mailing Address - Street 1:1 DEL POND DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2759
Mailing Address - Country:US
Mailing Address - Phone:781-821-0820
Mailing Address - Fax:781-821-0916
Practice Address - Street 1:1 DEL POND DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2759
Practice Address - Country:US
Practice Address - Phone:781-821-0820
Practice Address - Fax:781-821-0916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0974314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA225672Medicare ID - Type Unspecified