Provider Demographics
NPI:1083455828
Name:JUST ROOTS INC.
Entity type:Organization
Organization Name:JUST ROOTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:FALLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-325-8969
Mailing Address - Street 1:34 GLENBROOK DR APT 1B
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-9722
Mailing Address - Country:US
Mailing Address - Phone:413-325-8969
Mailing Address - Fax:
Practice Address - Street 1:34 GLENBROOK DR APT 1B
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-9722
Practice Address - Country:US
Practice Address - Phone:413-325-8969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No332U00000XSuppliersHome Delivered Meals