Countryside Nursing Home, Inc

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

0367 Issued in MA

Legal business name

COUNTRYSIDE NURSING HOME, INC

Practice address

153 Winter St
Framingham, MA 01702-2433

Phone

(508) 872-5250

Fax

(508) 872-1217

NPI assigned

Oct 4, 2005

Organization subpart

No

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

Authorized official

Name

Mr. John L Steacie

Title

Administrator

Phone

(508) 872-5250

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326035445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 WINTER ST",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017022433",
            "telephone_number": "508-872-5250",
            "fax_number": "508-872-1217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 WINTER ST",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017022433",
            "telephone_number": "508-872-5250",
            "fax_number": "508-872-1217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRYSIDE NURSING HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STEACIE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "508-872-5250",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MA",
            "license": "0367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0901547",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lydia Cottrell
• Amanda Coughlin, LICSW, MSW
• Deborah Kung Coughlin, LICSW
• Erin Coulson
• Courtney Charadi Council, MA, MS
• Carol Renee Counts Robinson, PHD, PMHNP-BC,ANP-BC
• Nicole Cournoyer
• Neide Coutinho, DMD
• Amy Claire Coutts
• Catherine Coutts, LICSW

• Nursing Facility/Intermediate Care Facility in Framingham, MA
• Providers in Framingham, MA by specialty
• Nursing Facility/Intermediate Care Facility in Massachusetts

• 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.