Provider Demographics
NPI:1528067394
Name:CARLETON-WILLARD HOMES, INC.
Entity type:Organization
Organization Name:CARLETON-WILLARD HOMES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-275-8700
Mailing Address - Street 1:100 OLD BILLERICA RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-1267
Mailing Address - Country:US
Mailing Address - Phone:781-275-8700
Mailing Address - Fax:781-276-1988
Practice Address - Street 1:100 OLD BILLERICA RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1267
Practice Address - Country:US
Practice Address - Phone:781-275-8700
Practice Address - Fax:781-276-1988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA870314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0913138Medicaid
MA226511Medicare ID - Type UnspecifiedCLINC PROVIDER NUMBER
MA0913138Medicaid
MA225273Medicare Oscar/Certification