1245302439 NPI number — SISTERS OF PROVIDENCE CARE CENTERS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245302439 NPI number — SISTERS OF PROVIDENCE CARE CENTERS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SISTERS OF PROVIDENCE CARE CENTERS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245302439
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35 HOLY FAMILY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLYOKE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01040-2701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-532-3246
Provider Business Mailing Address Fax Number:
413-532-0309

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
35 HOLY FAMILY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLYOKE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01040-2701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-532-3246
Provider Business Practice Location Address Fax Number:
413-532-0309
Provider Enumeration Date:
11/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
UMANA
Authorized Official First Name:
ERIKO
Authorized Official Middle Name:
KIMURA
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
413-532-3246

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  0786 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0924237 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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