Country Estates Nursing, L.L.C.

Organization Active NPI Skilled Nursing Facility · Agawam, MA

NPI 1437266558 · NPPES record last updated Jan 17, 2018

Key facts

NPI
1437266558
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
0967 (MA)
Legal business name
COUNTRY ESTATES NURSING, L.L.C.
Practice address
1200 Suffield St
Agawam, MA 01001-2933
Phone
(413) 789-2200
Fax
(413) 789-2269
NPI assigned
Aug 24, 2006
Organization subpart
No

Authorized official

Name
Ms. Marilyn Weaver
Title
Assistant Secretary
Phone
(502) 596-7563

National Provider Directory

Locations

1200 Suffield St
Agawam, MA 01001
Phone (413) 301-9300

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0967 MA Yes

Addresses

Primary practice location

1200 Suffield St
Agawam, MA 01001-2933

Mailing address

680 S 4TH St # KH-2
Louisville, KY 40202-2407

Other identifiers

IdentifierTypeStateIssuer
982257OtherMAMULTIPLAN
1190138OtherMAUNITED HEALTH CARE
000000024954OtherMABMC HEALTH NET
71-01051OtherMACIGNA
0029577OtherMAMARTINS POINT
225642OtherMACCS
0927929MedicaidMA
2222564201OtherMABLUE CROSS BLUE SHIELD

Other providers in Agawam, MA

All providers in Agawam, MA · Skilled Nursing Facility in Massachusetts

Sources for this page

Verify at the official NPI Registry.