1255402806 NPI number — VOLUNTEERS OF AMERICA OF MASSACHUSETTS INC

Table of content: (NPI 1255402806)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255402806 NPI number — VOLUNTEERS OF AMERICA OF MASSACHUSETTS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VOLUNTEERS OF AMERICA OF MASSACHUSETTS 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:
1255402806
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/17/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
441 CENTRE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JAMAICA PLAIN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02130-1831
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-822-4027
Provider Business Mailing Address Fax Number:
508-822-8257

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 POST OFFICE SQ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAUNTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02780-3206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-822-4027
Provider Business Practice Location Address Fax Number:
508-822-8257
Provider Enumeration Date:
11/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
MINDY
Authorized Official Middle Name:
M
Authorized Official Title or Position:
DIRECTOR OF OUTPATIENT SERVICES
Authorized Official Telephone Number:
508-822-4027

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X , with the licence number:  4372 , 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: 000000008470 . This is a "BOSTON MEDICAL CENTER HEA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1019410 . This is a "BEACON HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 715705000 . This is a "MAGELLAN BEHAVIORAL HEALT" identifier . This identifiers is of the category "OTHER".
  • Identifier: M18425 . This is a "BCBSMA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 613673 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1310399 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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