Healthcare Provider Details

I. General information

NPI: 1972670644
Provider Name (Legal Business Name): CALDWELL ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 06/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 MOHAWK TRL
SHELBURNE FALLS MA
01370-9705
US

IV. Provider business mailing address

904 MOHAWK TRL
SHELBURNE FALLS MA
01370-9705
US

V. Phone/Fax

Practice location:
  • Phone: 413-625-2305
  • Fax: 413-625-8422
Mailing address:
  • Phone: 413-625-2305
  • Fax: 413-625-8422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number225559
License Number StateMA

VIII. Authorized Official

Name: MR. DENNIS KEITH MCKENNA
Title or Position: ADMINISTRATOR
Credential: NHA
Phone: 413-625-2305