SRC Hampden, Inc.
Organization Active NPI Skilled Nursing Facility · Hampden, MA
NPI 1003867532 · NPPES record last updated Oct 5, 2012
Key facts
- NPI
- 1003867532
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0057 (MA)
- Legal business name
- SRC HAMPDEN, INC.
- Practice address
- 34 Main St
Hampden, MA 01036-9642 - Phone
- (413) 566-5511
- Fax
- (413) 566-8488
- NPI assigned
- May 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Tamilyn M. Levin, ESQ.
- Title
- Cfo
- Phone
- (781) 707-9510
National Provider Directory
Locations
63 Kendrick St
Needham Heights, MA 02494
Phone (781) 707-9085
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0057 | MA | Yes |
Addresses
Primary practice location
34 Main St
Hampden, MA 01036-9642
Mailing address
63 Kendrick St
Needham, MA 02494-2708
Phone (781) 707-9085
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110026455A | Medicaid | MA |
Other names
- Wingate at Hampden Rehab. & Skilled Nsg. Residence
Other providers in Hampden, MA
- Derek Robert Remy
- Benjamin Barry Seligman
- John E Shea
- Tristan Silva
- Soft Place Therapy, PLLC
- Surgical Associates of Springfield Inc
- Daniella L. Thomas
- Town of Hampden
- Town of Hampden- Fire Department
- Vantage at Hampden LLC
All providers in Hampden, MA · Skilled Nursing Facility in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.