Provider Demographics
NPI:1700896768
Name:NORTHAMPTON HEALTHCARE ASSOCIATES LLC
Entity Type:Organization
Organization Name:NORTHAMPTON HEALTHCARE ASSOCIATES LLC
Other - Org Name:NORTHAMPTON REHABILITATION AND NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:V
Authorized Official - Last Name:RASO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-686-4882
Mailing Address - Street 1:737 BRIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-1099
Mailing Address - Country:US
Mailing Address - Phone:413-586-3300
Mailing Address - Fax:413-586-4279
Practice Address - Street 1:737 BRIDGE ROAD
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-1099
Practice Address - Country:US
Practice Address - Phone:413-586-3300
Practice Address - Fax:413-586-4279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0775314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0929328Medicaid
MA0931039Medicaid
MA0929310Medicaid
MA0929328Medicaid