Beaumont Wards Lane Trust

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0160 Issued in MA

Legal business name

BEAUMONT WARDS LANE TRUST

Doing business as

Beaumont Nursing Home, Inc

Practice address

85 Beaumont Dr
Northbridge, MA 01534-1093

Phone

(508) 234-9771

Fax

(508) 234-2635

NPI assigned

Oct 3, 2005

Last updated

Mar 12, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gary Sacon

Title

Cfo

Phone

(508) 898-3490

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Beaumont Nursing Home, Inc Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331510400000",
    "number": "1033106356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 LYMAN ST",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015811442",
            "telephone_number": "508-898-3490",
            "fax_number": "508-898-1805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 BEAUMONT DR",
            "city": "NORTHBRIDGE",
            "state": "MA",
            "postal_code": "015341093",
            "telephone_number": "508-234-9771",
            "fax_number": "508-234-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUMONT WARDS LANE TRUST",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2012-03-12",
        "status": "A",
        "authorized_official_last_name": "SACON",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "508-898-3490",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0900419",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaumont Nursing Home, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barbara Alteri
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• Lisa Banian, NP-C
• Kristin Blair
• David Blake, PA-C
• Melanie Boisvert, PA-C
• Elizabeth Bolt
• Tonya A Bowzer, NP

• Skilled Nursing Facility in Northbridge, MA
• Providers in Northbridge, MA by specialty
• Skilled Nursing Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.