Provider Demographics
NPI:1134593858
Name:RESIDENCE AT VALLEY FARM
Entity type:Organization
Organization Name:RESIDENCE AT VALLEY FARM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SALDANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-532-3197
Mailing Address - Street 1:369 POND ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-2327
Mailing Address - Country:US
Mailing Address - Phone:508-532-3197
Mailing Address - Fax:508-532-3199
Practice Address - Street 1:369 POND ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MA
Practice Address - Zip Code:01721-2327
Practice Address - Country:US
Practice Address - Phone:508-532-3197
Practice Address - Fax:508-532-3199
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LCB SENIOR LIVING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3104A0630X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances