Provider Demographics
NPI:1891411674
Name:MASSACHUSETTS CARE SERVICES INC.
Entity type:Organization
Organization Name:MASSACHUSETTS CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:508-894-0060
Mailing Address - Street 1:37 BELMONT ST # D
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-5289
Mailing Address - Country:US
Mailing Address - Phone:508-232-5652
Mailing Address - Fax:
Practice Address - Street 1:37 BELMONT ST # D
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-5289
Practice Address - Country:US
Practice Address - Phone:508-232-5652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1528464609OtherVETERAN AFFAIR