Provider Demographics
NPI:1275906919
Name:METROWEST CENTER FOR INDEPENDENT LIVING
Entity Type:Organization
Organization Name:METROWEST CENTER FOR INDEPENDENT LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:W
Authorized Official - Last Name:SPOONER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-875-7853
Mailing Address - Street 1:280 IRVING ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-4300
Mailing Address - Country:US
Mailing Address - Phone:508-875-7853
Mailing Address - Fax:508-875-8359
Practice Address - Street 1:280 IRVING ST UNIT 2
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-4300
Practice Address - Country:US
Practice Address - Phone:508-875-7853
Practice Address - Fax:508-875-8359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management