MEDICARE: LABELLE'S REST HOME, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility	809	MA

General Provider Information

NPI Number	:	1295831956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LABELLE'S REST HOME, INC.

Provider Business Mailing Address
First Line	:	3 HIGH ST
Second Line	:
City	:	SHELBURNE FALLS
State	:	MA
Zip	:	01370-1205
Country	:	US
Telephone Number	:	413-625-6560
Fax Number	:	413-625-6104

Provider Business Practice Location Address
First Line	:	3 HIGH ST
Second Line	:
City	:	SHELBURNE FALLS
State	:	MA
Zip	:	01370-1205
Country	:	US
Telephone Number	:	413-625-6560
Fax Number	:	413-625-6104

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HAREN B UPADHYAY
Credential	:
Telephone Number	:	413-625-6560

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	08/22/2020

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