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NPI Code Detail

MEDICARE: MT GREYLOCK NURSING LLC

MEDICARE: MT GREYLOCK NURSING LLC
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
1314000000XSkilled Nursing Facility0893MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417170408
Entity Type Code : Organization
Provider Name (Legal Business Name) : MT GREYLOCK NURSING LLC
Provider Business Mailing Address
First Line : 1000 NORTH ST
Second Line :
City : PITTSFIELD
State : MA
Zip : 01201-1520
Country : US
Telephone Number : 413-499-7186
Fax Number : 413-499-3086
Provider Business Practice Location Address
First Line : 1000 NORTH ST
Second Line :
City : PITTSFIELD
State : MA
Zip : 01201-1520
Country : US
Telephone Number : 413-499-7186
Fax Number : 413-499-3086
Authorized Official
Title or Position : ASSOCIATE VICE PRESIDENT OF FINANCE
Name : MS. AMALE NEARY
Credential :
Telephone Number : 413-447-2416
Provider Enumeration Date : 04/10/2007
Last Update Date : 06/24/2008

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Directions to “MT GREYLOCK NURSING LLC ” Practice Location

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