Provider Demographics
NPI:1891521183
Name:THE BRIDGE OF CENTRAL MASSACHUSETTS, INC
Entity type:Organization
Organization Name:THE BRIDGE OF CENTRAL MASSACHUSETTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:T
Authorized Official - Last Name:BENVENUTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-318-7405
Mailing Address - Street 1:4 MANN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-3414
Mailing Address - Country:US
Mailing Address - Phone:508-755-0333
Mailing Address - Fax:
Practice Address - Street 1:288 GROVE ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3934
Practice Address - Country:US
Practice Address - Phone:508-755-0333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals