Provider Demographics
NPI:1902074362
Name:INTERFAITH SOCIAL SERVICES INC
Entity type:Organization
Organization Name:INTERFAITH SOCIAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-773-6203
Mailing Address - Street 1:105 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-2004
Mailing Address - Country:US
Mailing Address - Phone:617-773-6203
Mailing Address - Fax:617-472-4987
Practice Address - Street 1:105 ADAMS ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-2004
Practice Address - Country:US
Practice Address - Phone:617-773-6203
Practice Address - Fax:617-472-4987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA70010000P10048OtherPROVIDER LEGACY #