Provider Demographics
NPI:1730120619
Name:ADS PALM CHELMSFORD, INC.
Entity Type:Organization
Organization Name:ADS PALM CHELMSFORD, INC.
Other - Org Name:PALM MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DROPESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4231
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:610-925-4436
Mailing Address - Fax:610-925-4351
Practice Address - Street 1:40 PARKHURST RD
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1513
Practice Address - Country:US
Practice Address - Phone:978-256-3151
Practice Address - Fax:978-250-4942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0168314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2222550810OtherBC/BS - OUTPATIENT REHAB
551850OtherAETNA-HMO
MA0940267Medicaid
MA2222550801OtherBC/BS
31026OtherFALLON
71-00021OtherUNITED - EVERCARE
725684OtherTUFTS
903188OtherHARVARD PILGRIM
=========OtherAETNA-NONHMO
71-00021OtherUNITED - EVERCARE
=========OtherGREAT-WEST HEALTHCARE
MA2222550810OtherBC/BS - OUTPATIENT REHAB