Provider Demographics
NPI:1699012799
Name:COLONY CARE SENIOR LIVING, INC.
Entity Type:Organization
Organization Name:COLONY CARE SENIOR LIVING, INC.
Other - Org Name:COLONY CARE AT HOME
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:POPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-455-1122
Mailing Address - Street 1:74 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01105-1524
Mailing Address - Country:US
Mailing Address - Phone:413-455-1122
Mailing Address - Fax:888-805-4441
Practice Address - Street 1:74 WALNUT ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01105-1524
Practice Address - Country:US
Practice Address - Phone:413-455-1122
Practice Address - Fax:888-805-4441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-09
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health