WV-Concord SNF Opco, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WV-CONCORD SNF OPCO, LLC

Doing business as

Walden Health and Rehabilitation Center

Practice address

785 Main St
Concord, MA 01742-3310

Phone

(978) 369-6889

NPI assigned

Oct 5, 2016

Organization subpart

Yes

Parent organization

WACHUSETT VENTURES, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Raymond A. Dennehy III

Title

Principal

Phone

(978) 886-3336

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Walden Health and Rehabilitation Center Doing business as

Part of

Wachusett Ventures LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Wachusett Ventures LLC

  • Skilled Nursing Facility
  • Wellesley Hills, MA
  • NPI 1083065908
  NPPES parent name

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475625600000",
    "number": "1285184085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 WASHINGTON ST",
            "address_2": "SUITE 190",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024811900",
            "telephone_number": "781-943-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 MAIN ST",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017423310",
            "telephone_number": "978-369-6889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WV-CONCORD SNF OPCO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WACHUSETT VENTURES, LLC",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-10-05",
        "status": "A",
        "authorized_official_last_name": "DENNEHY",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "978-886-3336",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110100396A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walden Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Allen Wontka
• Cynthia Wood
• Alan Cox Woodward, M.D.
• Christopher Allen Worgul, M.D.
• Ting Wu
• Adeline Wyman Battalen, LICSW
• Mayra Yanes-Seyfarth, MS, RD, LDN
• Shelley Yang, M.D.
• Young S Yi, D.M.D.
• Landon Perini York

• Skilled Nursing Facility in Concord, MA
• Providers in Concord, 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 Oct 5, 2016; 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.