NPIMap

Organization Active NPI

Sisters of Providence Care CTRS Inc

  • Adult Care Home Facility
  • Holyoke, MA
National Provider Identifier
1790776698
Registry record updated Dec 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
879 Issued in MA
Legal business name
SISTERS OF PROVIDENCE CARE CTRS INC
Practice address
25 Brightside Dr
Holyoke, MA 01040-4033
Phone
(413) 532-4892
Fax
(413) 535-2355
NPI assigned
Oct 31, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2011

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

Authorized official

Name
Mr. Christopher John McLaughlin
Title
Coo, Mercy Continuing Care Network
Phone
(413) 539-2917

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 879 MA Primary

Addresses

Primary practice location

25 Brightside Dr
Holyoke, MA 01040-4033

Mailing address

1221 Main St
Catherine Horan Building, Suite 105
Holyoke, MA 01040-5394
Phone (413) 539-2618

Other identifiers 1

IdentifierTypeStateIssuer
5508304MedicaidMA

Other names 1

  • Beaven Kelly Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beaven Kelly Home4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

25 Brightside Dr
Holyoke, MA 01040
Phone (413) 532-4892

1221 Main St
Ste 105
Holyoke, MA 01040
Phone (413) 539-2918

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325203200000",
    "number": "1790776698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 MAIN ST",
            "address_2": "CATHERINE HORAN BUILDING, SUITE 105",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010405394",
            "telephone_number": "413-539-2618",
            "fax_number": "413-539-2859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 BRIGHTSIDE DR",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010404033",
            "telephone_number": "413-532-4892",
            "fax_number": "413-535-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISTERS OF PROVIDENCE CARE CTRS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2011-12-30",
        "status": "A",
        "authorized_official_last_name": "MCLAUGHLIN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "COO, MERCY CONTINUING CARE NETWORK",
        "authorized_official_telephone_number": "413-539-2917",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MA",
            "license": "879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5508304",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaven Kelly Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holyoke, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.