Healthcare Provider Details

I. General information

NPI: 1962701367
Provider Name (Legal Business Name): ENS HEALTH CARE OF THE BERKSHIRES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2011
Last Update Date: 03/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31A CHURCH STREET
LENOX MA
01240
US

IV. Provider business mailing address

1735 CENTRAL AVE
ALBANY NY
12205-4758
US

V. Phone/Fax

Practice location:
  • Phone: 413-551-7116
  • Fax:
Mailing address:
  • Phone: 518-452-3655
  • Fax: 518-452-0765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number8122
License Number StateMA

VIII. Authorized Official

Name: MS. SUZANNE C SMITH
Title or Position: CO-PRESIDENT
Credential: RN
Phone: 518-452-3655