Provider Demographics
NPI:1154460897
Name:PATRIOT ELDER CARE, INC.
Entity Type:Organization
Organization Name:PATRIOT ELDER CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOESPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHEMBRI
Authorized Official - Suffix:JR
Authorized Official - Credentials:EDD
Authorized Official - Phone:508-246-6493
Mailing Address - Street 1:239 CAUSEWAY ST
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-2900
Mailing Address - Country:US
Mailing Address - Phone:508-246-6493
Mailing Address - Fax:
Practice Address - Street 1:5 WALPOLE ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3351
Practice Address - Country:US
Practice Address - Phone:508-246-6493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1962103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9712411Medicaid
MAW10477OtherBCBSMA
MAW10477OtherBCBSMA