Organization Active NPI

61 Cooper Street Operations LLC

Doing business as Heritage Hall West

  • Skilled Nursing Facility
  • Agawam, MA
National Provider Identifier
1952583775
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0809 Issued in MA
Legal business name
61 COOPER STREET OPERATIONS LLC
Doing business as
Heritage Hall West
Practice address
61 Cooper St
Agawam, MA 01001-2149
Phone
(413) 786-8000
Fax
(413) 786-5066
NPI assigned
Dec 4, 2007
Last updated
Oct 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Authorized official

Name
Michael T Berg
Title
Secretary
Phone
(610) 444-6350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0809 MA Primary

Addresses

Primary practice location

61 Cooper St
Agawam, MA 01001-2149

Mailing address

101 E State St
Kennett Square, PA 19348-3109
Phone (610) 925-4436

Other identifiers 1

IdentifierTypeStateIssuer
110089065AMedicaidMA

Other names 1

  • Heritage Hall West Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759708800000",
    "number": "1952583775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "610-925-4436",
            "fax_number": "610-925-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 COOPER ST",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010012149",
            "telephone_number": "413-786-8000",
            "fax_number": "413-786-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "61 COOPER STREET OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "610-444-6350"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110089065A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Hall West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Agawam, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; 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.