Provider Demographics
NPI:1609864602
Name:NEWPORT LONG TERM CARE, INC.
Entity Type:Organization
Organization Name:NEWPORT LONG TERM CARE, INC.
Other - Org Name:MOUNTAINVIEW HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:COO
Authorized Official - Phone:413-562-0097
Mailing Address - Street 1:46 MAIN RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:MA
Mailing Address - Zip Code:01085-9511
Mailing Address - Country:US
Mailing Address - Phone:413-562-0097
Mailing Address - Fax:413-862-8092
Practice Address - Street 1:46 MAIN RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:MA
Practice Address - Zip Code:01085-9511
Practice Address - Country:US
Practice Address - Phone:413-562-0097
Practice Address - Fax:413-862-8092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0925977Medicaid
MA0925977Medicaid