MEDICARE: LONG TERM CENTERS OF NEW ENGLAND INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311Z00000X	Custodial Care Facility	1012	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124006481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONG TERM CENTERS OF NEW ENGLAND INC

Provider Business Mailing Address
First Line	:	84 MYRTLE ST
Second Line	:
City	:	ASHLAND
State	:	MA
Zip	:	01721-1113
Country	:	US
Telephone Number	:	508-881-1360
Fax Number	:	508-881-0012

Provider Business Practice Location Address
First Line	:	84 MYRTLE ST
Second Line	:
City	:	ASHLAND
State	:	MA
Zip	:	01721-1113
Country	:	US
Telephone Number	:	508-881-1360
Fax Number	:	508-881-0012

Authorized Official
Title or Position	:	PRESIDENT
Name	:	THOMAS E WOODS
Credential	:
Telephone Number	:	508-881-1360

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	08/22/2020

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