1366445546 NPI number — MULTICULTURAL COMMUNITY SERVICES OF THE PIONEER VALLEY INC.

Table of content: (NPI 1366445546)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366445546 NPI number — MULTICULTURAL COMMUNITY SERVICES OF THE PIONEER VALLEY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MULTICULTURAL COMMUNITY SERVICES OF THE PIONEER VALLEY 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:
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:
1366445546
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
96 INDUSTRY AVE
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01104-3241
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-782-7745
Provider Business Mailing Address Fax Number:
413-439-0373

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
96 INDUSTRY AVE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01104-3241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-782-7745
Provider Business Practice Location Address Fax Number:
413-439-0373
Provider Enumeration Date:
05/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
FLETCHER
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
413-782-2500

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , 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: 3755369 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: Q00643 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0600032 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000027802 . This is a "BMC HEALTHNET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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