OrganizationActive
464 Main Street Operations LLC
NPI 1699957415 · Skilled Nursing Facility · Agawam, MA
Provider details
- NPI number
- 1699957415
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Michael Berg, Asst Secretary(505) 468-4742
- License
- 0875 (MA)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
464 Main St
Agawam, MA 01001-1826
Phone: (412) 786-8000
Fax: (413) 789-1099
Approximate (ZIP-level) locationGet directions
Mailing address
101 E State St
Kennett Square, PA 19348-3109
Other names (DBA / former)
- Doing business as
- Memory Support of Heritage Hall
Registry dates
- Enumerated
- 2007-12-04
- Last updated
- 2020-10-23
- Certified
- 2020-10-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.