Provider Demographics
NPI:1548254048
Name:SOUTHPOINTE NURSING HOME, INC
Entity type:Organization
Organization Name:SOUTHPOINTE NURSING HOME, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:M
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-675-2500
Mailing Address - Street 1:100 AMITY ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-2202
Mailing Address - Country:US
Mailing Address - Phone:508-675-2500
Mailing Address - Fax:508-675-8874
Practice Address - Street 1:100 AMITY ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-2202
Practice Address - Country:US
Practice Address - Phone:508-675-2500
Practice Address - Fax:508-675-8874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0955314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0921157Medicaid
MA0921157Medicaid