Organization
SRC WEST SPRINGFIELD, INC.
Active
Other names
Wingate at West Springfield Rehab. & Skilled Nsg. Residence
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMILYN M. LEVIN ESQ. (CFO)
(781) 707-9510
Entity
Organization
Contact information
Practice address
42 PROSPECT AVE, WEST SPRINGFIELD, MA 01089-4510
(413) 733-3151
(413) 731-9984
Mailing address
63 KENDRICK ST, NEEDHAM, MA 02494-2708
(781) 707-9085
(781) 707-9285
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0068
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0927481
—
MA
05
—
110026486B
—
MA
Enumeration date
05/12/2006
Last updated
10/05/2012
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