Provider Demographics
NPI:1780812693
Name:OVERLOOK HEALTH CENTER AT NORTHAMPTON, INC
Entity type:Organization
Organization Name:OVERLOOK HEALTH CENTER AT NORTHAMPTON, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-434-2402
Mailing Address - Street 1:88 MASONIC HOME RD
Mailing Address - Street 2:
Mailing Address - City:CHARLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01507-1394
Mailing Address - Country:US
Mailing Address - Phone:508-434-2412
Mailing Address - Fax:508-248-3905
Practice Address - Street 1:222 RIVER RD
Practice Address - Street 2:
Practice Address - City:LEEDS
Practice Address - State:MA
Practice Address - Zip Code:01053-9783
Practice Address - Country:US
Practice Address - Phone:508-434-2412
Practice Address - Fax:508-248-3905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-30
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110084393AMedicaid
MA110084393AMedicaid