Healthcare Provider Details

I. General information

NPI: 1205285491
Provider Name (Legal Business Name): SHORELINE HEALTHCARE CENTER OF GREENFIELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2016
Last Update Date: 06/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

359 HIGH ST
GREENFIELD MA
01301-2617
US

IV. Provider business mailing address

359 HIGH ST
GREENFIELD MA
01301-2617
US

V. Phone/Fax

Practice location:
  • Phone: 413-774-6318
  • Fax:
Mailing address:
  • Phone: 413-774-6318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: SEAN CARNEY
Title or Position: PRESIDENT
Credential:
Phone: 401-741-7199