Provider Demographics
NPI:1215094511
Name:HAMPSHIRE COUNCIL OF GOVERNMENTS
Entity type:Organization
Organization Name:HAMPSHIRE COUNCIL OF GOVERNMENTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICER/FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-584-1300
Mailing Address - Street 1:PO BOX 313
Mailing Address - Street 2:
Mailing Address - City:LEEDS
Mailing Address - State:MA
Mailing Address - Zip Code:01053-0313
Mailing Address - Country:US
Mailing Address - Phone:413-584-8457
Mailing Address - Fax:413-585-8735
Practice Address - Street 1:222 RIVER RD
Practice Address - Street 2:
Practice Address - City:LEEDS
Practice Address - State:MA
Practice Address - Zip Code:01053-0313
Practice Address - Country:US
Practice Address - Phone:413-584-8457
Practice Address - Fax:413-585-8735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0913014Medicaid
MA0913014Medicaid