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General NPI Number Information
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NPI Number | 1104812379
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Entity Type | Organization
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Legal Business Name | SARAWOOD RETIREMENT HOME, INC.
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1 LOOMIS AVE
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City | HOLYOKE
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State | MA
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Zip | 01040-2011
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Country | US
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Telephone | 413-532-7879
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Fax | 413-535-2015
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Provider Business Mailing Address
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Address Line | 1 LOOMIS AVE
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City | HOLYOKE
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State | MA
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Zip | 01040-2011
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Country | US
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Telephone | 413-532-7879
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Fax | 413-535-2015
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. WILLIAM G. LYONS
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Credential |
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Telephone | 413-532-7879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 1905236
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License Number State | MA
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