Provider Demographics
NPI:1154877710
Name:CLINICAL & SUPPORT OPRTIONS
Entity type:Organization
Organization Name:CLINICAL & SUPPORT OPRTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESPITE COUNSELOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:TENZIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YANGZOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-522-4870
Mailing Address - Street 1:60 SEARS ST # 2
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:01370-1317
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 ARCH STREET #1
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301
Practice Address - Country:US
Practice Address - Phone:413-774-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care