Provider Demographics
NPI:1033409057
Name:FIRST RESPONSE CLINICAL SERVICES, LLC
Entity Type:Organization
Organization Name:FIRST RESPONSE CLINICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYBETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:508-259-1209
Mailing Address - Street 1:364 WOOD ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1026
Mailing Address - Country:US
Mailing Address - Phone:508-259-1209
Mailing Address - Fax:508-435-0977
Practice Address - Street 1:20 HOPE AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-2721
Practice Address - Country:US
Practice Address - Phone:866-604-0911
Practice Address - Fax:508-435-0977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN230945261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty