Provider Demographics
NPI:1205285491
Name:SHORELINE HEALTHCARE CENTER OF GREENFIELD
Entity type:Organization
Organization Name:SHORELINE HEALTHCARE CENTER OF GREENFIELD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-741-7199
Mailing Address - Street 1:359 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-2617
Mailing Address - Country:US
Mailing Address - Phone:413-774-6318
Mailing Address - Fax:
Practice Address - Street 1:359 HIGH ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2617
Practice Address - Country:US
Practice Address - Phone:413-774-6318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHORELINE HEALTHCARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility