Provider Demographics
NPI:1194706184
Name:NORTHERN BERKSHIRE COMMUNITY SERVICES INC
Entity type:Organization
Organization Name:NORTHERN BERKSHIRE COMMUNITY SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL SERVICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:B
Authorized Official - Last Name:RAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-458-8127
Mailing Address - Street 1:1561 COLD SPRING RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01267-2743
Mailing Address - Country:US
Mailing Address - Phone:413-458-8127
Mailing Address - Fax:413-458-8209
Practice Address - Street 1:1561 COLD SPRING RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:MA
Practice Address - Zip Code:01267-2743
Practice Address - Country:US
Practice Address - Phone:413-458-8127
Practice Address - Fax:413-458-8209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3973314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0925608Medicaid
MA0925608Medicaid