Provider Demographics
NPI:1922097633
Name:WESTERN MASSACHUSETTS LIFECARE CORPORATION, INC
Entity Type:Organization
Organization Name:WESTERN MASSACHUSETTS LIFECARE CORPORATION, INC
Other - Org Name:REEDS LANDING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WINTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-782-1800
Mailing Address - Street 1:807 WILBRAHAM RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01109-2067
Mailing Address - Country:US
Mailing Address - Phone:413-782-1800
Mailing Address - Fax:413-782-8038
Practice Address - Street 1:807 WILBRAHAM RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109-2067
Practice Address - Country:US
Practice Address - Phone:413-782-1800
Practice Address - Fax:413-782-8038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-14
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0990314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0922315Medicaid
MA0922315Medicaid