Provider Demographics
NPI:1972599124
Name:WEST BOYLSTON NURSING HOME INC
Entity Type:Organization
Organization Name:WEST BOYLSTON NURSING HOME INC
Other - Org Name:OAKDALE REHABILITATION AND SKILLED NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ORIOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-829-1110
Mailing Address - Street 1:54 BOYDEN ROAD
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-2570
Mailing Address - Country:US
Mailing Address - Phone:508-829-1110
Mailing Address - Fax:508-829-1235
Practice Address - Street 1:76 N MAIN STREET
Practice Address - Street 2:
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-1130
Practice Address - Country:US
Practice Address - Phone:508-829-1110
Practice Address - Fax:508-829-1235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0915513Medicaid
MA225334Medicare Oscar/Certification