Quabbin Valley Convalescent Center,Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0071 Issued in MA

Legal business name

QUABBIN VALLEY CONVALESCENT CENTER,INC.

Doing business as

Quabbin Valley Healthcare

Practice address

821 Daniel Shays Hwy
Athol, MA 01331-9609

Phone

(978) 249-3717

Fax

(978) 249-7700

NPI assigned

Sep 20, 2005

Organization subpart

No

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

Authorized official

Name

Diane O'Brien

Title

Administrator

Phone

(978) 249-3717

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Quabbin Valley Healthcare Doing business as

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322524800000",
    "number": "1649266214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 DANIEL SHAYS HWY",
            "city": "ATHOL",
            "state": "MA",
            "postal_code": "013319609",
            "telephone_number": "978-249-3717",
            "fax_number": "978-249-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 DANIEL SHAYS HWY",
            "city": "ATHOL",
            "state": "MA",
            "postal_code": "013319609",
            "telephone_number": "978-249-3717",
            "fax_number": "978-249-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUABBIN VALLEY CONVALESCENT CENTER,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-20",
        "last_updated": "2011-11-29",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "978-249-3717"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0915483",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quabbin Valley Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Athol, MA
• Providers in Athol, 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 Nov 29, 2011; 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.