Provider Demographics
NPI:1114161353
Name:CATHOLIC CHARITIES OF THE DIOCESE OF WORCESTER
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES OF THE DIOCESE OF WORCESTER
Other - Org Name:MERCY CENTRE
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCMAHON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-860-2205
Mailing Address - Street 1:10 HAMMOND ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01610-1513
Mailing Address - Country:US
Mailing Address - Phone:508-798-0191
Mailing Address - Fax:508-797-5659
Practice Address - Street 1:25 W CHESTER ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-1137
Practice Address - Country:US
Practice Address - Phone:508-852-7165
Practice Address - Fax:508-856-9755
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHOLIC CHARITIES OF THE DIOCESE OF WORCESTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-30
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services