Provider Demographics
NPI:1407952872
Name:TOWN OF LEICESTER BOARD OF HEALTH
Entity Type:Organization
Organization Name:TOWN OF LEICESTER BOARD OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MONTIVERDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-892-7008
Mailing Address - Street 1:3 WASHBURN SQ
Mailing Address - Street 2:
Mailing Address - City:LEICESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01524-1333
Mailing Address - Country:US
Mailing Address - Phone:508-892-7008
Mailing Address - Fax:508-892-7500
Practice Address - Street 1:3 WASHBURN SQ
Practice Address - Street 2:
Practice Address - City:LEICESTER
Practice Address - State:MA
Practice Address - Zip Code:01524-1333
Practice Address - Country:US
Practice Address - Phone:508-892-7008
Practice Address - Fax:508-892-7500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare