Provider Demographics
NPI:1023358819
Name:CHD
Entity Type:Organization
Organization Name:CHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:AJWALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-559-8311
Mailing Address - Street 1:10 PORTER AVE
Mailing Address - Street 2:APT A
Mailing Address - City:HATFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01038-9706
Mailing Address - Country:US
Mailing Address - Phone:413-559-8311
Mailing Address - Fax:
Practice Address - Street 1:10 PORTER AVE
Practice Address - Street 2:APT A
Practice Address - City:HATFIELD
Practice Address - State:MA
Practice Address - Zip Code:01038-9706
Practice Address - Country:US
Practice Address - Phone:413-559-8311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care