Provider Demographics
NPI:1043688294
Name:AVIDITY CARE
Entity Type:Organization
Organization Name:AVIDITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT, SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:YERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:413-388-7633
Mailing Address - Street 1:PO BOX 4555
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01014-4555
Mailing Address - Country:US
Mailing Address - Phone:413-650-1474
Mailing Address - Fax:
Practice Address - Street 1:264 EXCHANGE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01013-1615
Practice Address - Country:US
Practice Address - Phone:413-650-1474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-04
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care