NPIMap

Organization Active NPI

Massachusetts Assisted Living LLC

Doing business as The Village at Laurel Lake

  • Assisted Living Facility
  • Lee, MA
National Provider Identifier
1093930364
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
MASSACHUSETTS ASSISTED LIVING LLC
Doing business as
The Village at Laurel Lake
Practice address
600 Laurel St
Lee, MA 01238-3800
Phone
(413) 243-4747
Fax
(413) 243-4604
NPI assigned
Apr 13, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Arthur L. Rothgerber
Title
Senior VP of Reimbursement
Phone
(502) 596-7300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X MA Primary

Addresses

Primary practice location

600 Laurel St
Lee, MA 01238-3800

Mailing address

600 Laurel St
Lee, MA 01238-3800
Phone (413) 243-4747

Other identifiers 1

IdentifierTypeStateIssuer
1903870MedicaidMA

Other names 1

  • The Village at Laurel Lake Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Avery Crossings2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093930364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 LAUREL ST",
            "city": "LEE",
            "state": "MA",
            "postal_code": "012383800",
            "telephone_number": "413-243-4747",
            "fax_number": "413-243-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 LAUREL ST",
            "city": "LEE",
            "state": "MA",
            "postal_code": "012383800",
            "telephone_number": "413-243-4747",
            "fax_number": "413-243-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASSACHUSETTS ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROTHGERBER",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "SENIOR VP OF REIMBURSEMENT",
        "authorized_official_telephone_number": "502-596-7300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1903870",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Village at Laurel Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lee, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.