Provider Demographics
NPI:1275676082
Name:CHRISTOPHER HOUSE OF ATTLEBORO LP
Entity Type:Organization
Organization Name:CHRISTOPHER HOUSE OF ATTLEBORO LP
Other - Org Name:CHRISTOPHER HEIGHTS OF ATTLEBORO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:A
Authorized Official - Last Name:OHANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-222-2868
Mailing Address - Street 1:45 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2919
Mailing Address - Country:US
Mailing Address - Phone:508-222-2868
Mailing Address - Fax:508-226-5598
Practice Address - Street 1:45 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2919
Practice Address - Country:US
Practice Address - Phone:508-222-2868
Practice Address - Fax:508-226-5598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1900021Medicaid