Provider Demographics
NPI:1538302559
Name:COMMUNITY HEALTH LINK
Entity Type:Organization
Organization Name:COMMUNITY HEALTH LINK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:OSHLAG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-860-1163
Mailing Address - Street 1:76 JAQUES AVENUE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01610-2480
Mailing Address - Country:US
Mailing Address - Phone:508-860-1163
Mailing Address - Fax:
Practice Address - Street 1:100 ERDMAN WAY
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-1804
Practice Address - Country:US
Practice Address - Phone:978-466-8384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA=========OtherMENTALHEALTH NON-PROFIT