Healthcare Provider Details

I. General information

NPI: 1174607956
Provider Name (Legal Business Name): WILLOWOOD OF NORTH ADAMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 02/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 FRANKLIN ST
NORTH ADAMS MA
01247-2712
US

IV. Provider business mailing address

175 FRANKLIN ST
NORTH ADAMS MA
01247-2712
US

V. Phone/Fax

Practice location:
  • Phone: 413-664-4041
  • Fax: 413-664-1027
Mailing address:
  • Phone: 413-664-4041
  • Fax: 413-664-1027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0013
License Number StateMA

VIII. Authorized Official

Name: MR. WILLIAM C JONES
Title or Position: PRESIDENT
Credential:
Phone: 413-447-2996