Healthcare Provider Details

I. General information

NPI: 1649539388
Provider Name (Legal Business Name): ATC TRAVELERS NURSES & ALLIED PROFESSIONALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2012
Last Update Date: 05/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 HATHAWAY RD
WESTHAMPTON MA
01027-9508
US

IV. Provider business mailing address

3 HATHAWAY RD
WESTHAMPTON MA
01027-9508
US

V. Phone/Fax

Practice location:
  • Phone: 413-575-4055
  • Fax:
Mailing address:
  • Phone: 413-575-4055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number12106878
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number7148
License Number StateMA

VIII. Authorized Official

Name: DENISE GREENWOOD
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: M. A. CCC-SLP
Phone: 413-575-4055