BEAVEN KELLY HOME
NPI 1790776698
Custodial Care Facility - Adult Care Home in Holyoke, MA

NPI Status: Active since October 31, 2005

Contact Information

25 BRIGHTSIDE DR
HOLYOKE, MA
ZIP 01040
Phone: (413) 532-4892
Fax: (413) 535-2355

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  • Organization
  • Custodial Care Facility
  • Adult Care Home
  • CLIA Number: 22D2202850
  • CLIA Cert. Type: Other - INDPENDENT LIVING FACILIT
  • CLIA Exp. Date: 11-30-2026

About BEAVEN KELLY HOME

This page provides the complete NPI Profile along with additional information for Beaven Kelly Home, a provider established in Holyoke, Massachusetts operating as a Custodial Care Facility, focusing in adult care home . The healthcare provider is registered in the NPI registry with number 1790776698 assigned on October 2005. The practitioner's primary taxonomy code is 311ZA0620X with license number 879 (MA). The provider is registered as an organization and their NPI record was last updated 14 years ago. The provider's is doing business as Beaven Kelly Home. The authorized official of this NPI record is Mr. Christopher John Mclaughlin (Coo, Mercy Continuing Care Network)

NPI
1790776698
Provider Legal Name
SISTERS OF PROVIDENCE CARE CTRS INC
Other Organization Name
BEAVEN KELLY HOME
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
25 BRIGHTSIDE DR HOLYOKE, MA 01040
Location Phone
(413) 532-4892
Location Fax
(413) 535-2355
Mailing Address
1221 MAIN ST CATHERINE HORAN BUILDING, SUITE 105 HOLYOKE, MA 01040
Mailing Phone
(413) 539-2618
Mailing Fax
(413) 535-2355
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-31-2005
Last Update Date
12-30-2011
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Custodial Care Facility Adult Care Home

Taxonomy Code
311ZA0620X
Type
Nursing & Custodial Care Facilities
License No.
879
License State
MA
Taxonomy Description
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. CHRISTOPHER JOHN MCLAUGHLIN

Authorized Official Title
COO, MERCY CONTINUING CARE NETWORK
Authorized Official Phone
(413) 539-2917

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
5508304MEDICAID (05)MA 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
22D2202850
Facility Type
Other - INDPENDENT LIVING FACILIT
Certificate Effective Date
December 01, 2024
Certificate Expiration Date
November 30, 2026
Laboratory Director
LORI HANNAH
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Beaven Kelly Home to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1790776698, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
0
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
7
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
6
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 7 → 14 → 5 6 → 12 → 3 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 8 + 0 + 1 + 4 + 7 + 1 + 2 + 6 + 1 + 8 + 24 = 72

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 72 is 80. The difference is the calculated check digit.

80 - 72 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1790776698.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Custodial Care Facility (Adult Care Home)
25 BRIGHTSIDE DR
HOLYOKE, MA 01040

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1790776698, enumerated as an "organization" on October 31, 2005.

The provider is located at 25 BRIGHTSIDE DR HOLYOKE, MA 01040 and the phone number is (413) 532-4892.

Custodial Care Facility with taxonomy code 311ZA0620X and a focus in Adult Care Home.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.