Provider Demographics
NPI:1184007205
Name:ELIOT COMMUNITY HUMAN SERVICES
Entity Type:Organization
Organization Name:ELIOT COMMUNITY HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VOCATIONAL SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:GRAD STUDENT
Authorized Official - Phone:781-264-3859
Mailing Address - Street 1:72 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189-2935
Mailing Address - Country:US
Mailing Address - Phone:781-264-3859
Mailing Address - Fax:
Practice Address - Street 1:72 HIGH ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-2935
Practice Address - Country:US
Practice Address - Phone:781-264-3859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management