Provider Demographics
NPI:1366445546
Name:MULTICULTURAL COMMUNITY SERVICES OF THE PIONEER VALLEY INC.
Entity Type:Organization
Organization Name:MULTICULTURAL COMMUNITY SERVICES OF THE PIONEER VALLEY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CONLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-782-2500
Mailing Address - Street 1:96 INDUSTRY AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-3241
Mailing Address - Country:US
Mailing Address - Phone:413-782-7745
Mailing Address - Fax:413-439-0373
Practice Address - Street 1:96 INDUSTRY AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3241
Practice Address - Country:US
Practice Address - Phone:413-782-7745
Practice Address - Fax:413-439-0373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0600032Medicaid
MA3755369OtherAETNA
MA000000027802OtherBMC HEALTHNET
MAQ00643OtherBLUE CROSS BLUE SHIELD
MA227472Medicare ID - Type Unspecified