Mary Lyon Nursing and Rehabilitation Center
Organization Active NPI Skilled Nursing Facility · Hampden, MA
NPI 1790775336 · NPPES record last updated Jun 24, 2008
Key facts
- NPI
- 1790775336
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0057 (MA)
- Legal business name
- MARY LYON NURSING AND REHABILITATION CENTER
- Practice address
- 34 Main St
Hampden, MA 01036-9642 - Phone
- (413) 566-5511
- Fax
- (413) 566-8488
- NPI assigned
- Oct 25, 2005
- Organization subpart
- No
Authorized official
- Name
- Debra Decoteau
- Title
- Accounts Receivable Regional Manage
- Phone
- (413) 335-3318
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0057 | MA | Yes |
Addresses
Primary practice location
34 Main St
Hampden, MA 01036-9642
Mailing address
34 Main St
Hampden, MA 01036-9642
Phone (413) 566-5511
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0929191 | Medicaid | MA |
Other names
- Radius 91 Lyons Operating, LLC
Other providers in Hampden, MA
- Danielle Love Lawrence
- Kathleen Marie Lee
- Maryam Lempke
- Luna Frith, LLC
- Karl William Martin
- Amberly Matt
- Kathleen Page
- Denise Marie Pelletier
- Sabrina Raffaele
- Derek Robert Remy
All providers in Hampden, 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 Jun 24, 2008. 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.