55 Cooper Street Operations LLC
Organization Active NPI Skilled Nursing Facility · Agawam, MA
NPI 1508048323 · NPPES record last updated Oct 6, 2025
Key facts
- NPI
- 1508048323
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0731 (MA)
- Legal business name
- 55 COOPER STREET OPERATIONS LLC
- Practice address
- 55 Cooper St
Agawam, MA 01001-2149 - Phone
- (413) 786-8000
- Fax
- (413) 789-4735
- NPI assigned
- Dec 4, 2007
- Organization subpart
- No
Authorized official
- Name
- Michael T Berg
- Title
- Secretary
- Phone
- (610) 444-6350
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0731 | MA | Yes |
Addresses
Primary practice location
55 Cooper St
Agawam, MA 01001-2149
Mailing address
101 E State St
Kennett Square, PA 19348-3109
Phone (610) 925-4436
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110089100A | Medicaid | MA |
Other names
- Heritage Hall North
Other providers in Agawam, MA
- 1200 Suffield Street Operator LLC
- 462 Main Street Opco, LLC
- 464 Main Street Operations LLC
- 61 Cooper Street Operations LLC
- 65 Cooper Street Operations LLC
- A Dental Group
- Michael Scott Abrams
- Renato Opura Acuna
All providers in Agawam, MA · Skilled Nursing Facility in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.