Provider Demographics
NPI:1518614742
Name:TOWN OF LEE
Entity Type:Organization
Organization Name:TOWN OF LEE
Other - Org Name:TRI-TOWN HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILUSZ
Authorized Official - Suffix:
Authorized Official - Credentials:RS
Authorized Official - Phone:413-243-5540
Mailing Address - Street 1:45 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:LEE
Mailing Address - State:MA
Mailing Address - Zip Code:01238-1639
Mailing Address - Country:US
Mailing Address - Phone:413-243-5540
Mailing Address - Fax:
Practice Address - Street 1:45 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:LEE
Practice Address - State:MA
Practice Address - Zip Code:01238-1639
Practice Address - Country:US
Practice Address - Phone:413-243-5540
Practice Address - Fax:413-243-5540
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWN OF LEE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-08
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local