Provider Demographics
NPI:1619733078
Name:WESTERN MASSACHUSETTS BEHAVIORAL HOSPITAL LLC
Entity Type:Organization
Organization Name:WESTERN MASSACHUSETTS BEHAVIORAL HOSPITAL LLC
Other - Org Name:CHANGES VALLEY SPRINGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HEMANSUROY
Authorized Official - Middle Name:
Authorized Official - Last Name:SASENARAINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-623-0229
Mailing Address - Street 1:157 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-2614
Mailing Address - Country:US
Mailing Address - Phone:413-466-6170
Mailing Address - Fax:413-259-8781
Practice Address - Street 1:157 HIGH ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2614
Practice Address - Country:US
Practice Address - Phone:413-466-6170
Practice Address - Fax:413-259-8781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-23
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes283Q00000XHospitalsPsychiatric HospitalGroup - Multi-Specialty