Provider Demographics
NPI:1417980970
Name:COMMUNITY HEALTH ASSOCIATION OF RICHMOND AND WEST STOCKBRIDGE
Entity Type:Organization
Organization Name:COMMUNITY HEALTH ASSOCIATION OF RICHMOND AND WEST STOCKBRIDGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:413-232-0122
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:21 STATE LINE RD.
Mailing Address - City:WEST STOCKBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01266
Mailing Address - Country:US
Mailing Address - Phone:413-232-0122
Mailing Address - Fax:413-232-0199
Practice Address - Street 1:21 STATE LINE RD.
Practice Address - Street 2:
Practice Address - City:WEST STOCKBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01266
Practice Address - Country:US
Practice Address - Phone:413-232-0122
Practice Address - Fax:413-232-0199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0602337Medicaid
MA0602337Medicaid