Provider Demographics
NPI:1003592957
Name:COMMONWEALTH LAND TRUST, INC.
Entity Type:Organization
Organization Name:COMMONWEALTH LAND TRUST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:IVA
Authorized Official - Middle Name:
Authorized Official - Last Name:COMEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-445-4075
Mailing Address - Street 1:1059 TREMONT STREET SUITE 2
Mailing Address - Street 2:
Mailing Address - City:ROXBURY CROSSING
Mailing Address - State:MA
Mailing Address - Zip Code:02120
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1059 TREMONT STREET SUITE 2
Practice Address - Street 2:
Practice Address - City:ROXBURY CROSSING
Practice Address - State:MA
Practice Address - Zip Code:02120
Practice Address - Country:US
Practice Address - Phone:617-445-4075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management