Healthcare Provider Details

I. General information

NPI: 1871588608
Provider Name (Legal Business Name): HOLDEN NURSING HOME, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 05/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 MAYO DR
HOLDEN MA
01520-1512
US

IV. Provider business mailing address

54 BOYDEN RD
HOLDEN MA
01520-2570
US

V. Phone/Fax

Practice location:
  • Phone: 508-829-1110
  • Fax: 508-829-1235
Mailing address:
  • Phone: 508-829-1110
  • Fax: 508-829-1235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number110025736C
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3140N1450X
TaxonomyPediatric Skilled Nursing Facility
License Number110025736B
License Number StateMA

VIII. Authorized Official

Name: MR. ROBERT ORIOL
Title or Position: ADMINISTRATOR
Credential:
Phone: 508-829-1110