239 Cross Road LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

239 CROSS ROAD LLC

Doing business as

Autumn Glen at Dartmouth

Practice address

239 Cross Rd
Dartmouth, MA 02747-1992

Phone

(508) 992-8880

NPI assigned

Dec 30, 2016

Last updated

Jan 30, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Shawn M Bertram

Title

VP of Operations

Phone

(508) 404-3534

Specialties & licenses 1

Addresses

Other names 1

• Autumn Glen at Dartmouth Doing business as

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

{
    "created_epoch": "1483056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485734400000",
    "number": "1932644994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 CROSS RD",
            "city": "N DARTMOUTH",
            "state": "MA",
            "postal_code": "027471992",
            "telephone_number": "508-992-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 CROSS RD",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027471992",
            "telephone_number": "508-992-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "239 CROSS ROAD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-30",
        "last_updated": "2017-01-30",
        "status": "A",
        "authorized_official_last_name": "BERTRAM",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "508-404-3534",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Glen at Dartmouth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Dartmouth, MA
• Providers in Dartmouth, MA by specialty
• Assisted Living Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; 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.