Provider Demographics
NPI:1083765242
Name:MJG MANAGEMENT ASSOCIATES, INC.
Entity Type:Organization
Organization Name:MJG MANAGEMENT ASSOCIATES, INC.
Other - Org Name:AT HOME VNA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JERRY
Authorized Official - Last Name:GALATIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:617-416-9591
Mailing Address - Street 1:1050 WINTER ST
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1401
Mailing Address - Country:US
Mailing Address - Phone:617-416-9591
Mailing Address - Fax:
Practice Address - Street 1:1050 WINTER ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1401
Practice Address - Country:US
Practice Address - Phone:617-416-9591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0600270251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0600270Medicaid
MA0600270Medicaid