Provider Demographics
NPI:1093182206
Name:COMMUNITY LINK
Entity Type:Organization
Organization Name:COMMUNITY LINK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:KATANDULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-286-9344
Mailing Address - Street 1:3 THOMAS STREET
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826
Mailing Address - Country:US
Mailing Address - Phone:617-286-9344
Mailing Address - Fax:
Practice Address - Street 1:3 THOMAS STREET
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826
Practice Address - Country:US
Practice Address - Phone:617-286-9344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty