- Enrollment id
- O20171013000852
- Enrollment state
- MA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1508398082
- Multiple npi flag
- N
- Ccn
- 225495
- Associate id
- 3870868094
- Organization name
- BEAR MOUNTAIN 320 OPERATING LLC
- Doing business as name
- TIMBERLYN HEIGHTS NURSING AND REHABILITATION
- Incorporation date
- 2017-02-27
- Incorporation state
- CT
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- TIMBERLYN HEIGHTS NURSING AND REHABILITATION
- Address line 1
- 320 MAPLE AVE
- City
- GREAT BARRINGTON
- State
- MA
- Zip code
- 012301951