Provider Demographics
NPI:1518946904
Name:HILLTOWN COMMUNITY HEALTH CENTERS, INC.
Entity Type:Organization
Organization Name:HILLTOWN COMMUNITY HEALTH CENTERS, INC.
Other - Org Name:HUNTINGTON HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZA
Authorized Official - Middle Name:B
Authorized Official - Last Name:LAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-238-5511
Mailing Address - Street 1:73 RUSSELL RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01050-9777
Mailing Address - Country:US
Mailing Address - Phone:413-667-3009
Mailing Address - Fax:413-667-8746
Practice Address - Street 1:73 RUSSELL RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:MA
Practice Address - Zip Code:01050-9777
Practice Address - Country:US
Practice Address - Phone:413-667-3009
Practice Address - Fax:413-667-8746
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HILLTOWN COMMUNITY HEALTH CENTERS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-13
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4950251V00000X
261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1320866Medicaid
MAM16638OtherBLUE CROSS BLUE SHIELD
MA1320866Medicaid