Memory Support Of Heritage Hall

LBN: 464 Main Street Operations Llc
Memory Support Of Heritage Hall is an health care organization with primary practice located at 464 Main St , Agawam MA 01001-1826. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. 464 Main Street Operations Llc can be contacted via phone (412) 786-8000, or through Berg, Michael T via phone (505) 468-4742.

Contact Information

Primary practice address
464 Main St Agawam MA 01001-1826
Phone: (412) 786-8000
Fax: (413) 789-1099
Website:
Map and Directions
Authorized official contact:
Name: Berg, Michael T
Phone: (505) 468-4742

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 0875 Massachusetts

Profile Details

NPI number 1699957415
LBN Legal business name 464 Main Street Operations Llc
DBA Doing business as Memory Support Of Heritage Hall
Authorized official Berg, Michael T
Entity Organization
Organization subpart 1 No
Enumeration date Dec 4th, 2007
Last updated Oct 23rd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699957415 NPPES
Massachusetts MEDICAID 110088864A

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