Provider Demographics
NPI:1528197464
Name:MANAGED HEALTH RESOURC INC
Entity Type:Organization
Organization Name:MANAGED HEALTH RESOURC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNELL
Authorized Official - Suffix:I
Authorized Official - Credentials:CEO
Authorized Official - Phone:617-718-2640
Mailing Address - Street 1:259 LOWELL ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2666
Mailing Address - Country:US
Mailing Address - Phone:617-718-2640
Mailing Address - Fax:617-718-2637
Practice Address - Street 1:259 LOWELL ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2666
Practice Address - Country:US
Practice Address - Phone:617-718-2640
Practice Address - Fax:617-718-2637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health