Provider Demographics
NPI:1639334782
Name:HEALTH AWARENESS SERVICES OF CENTRAL MA
Entity Type:Organization
Organization Name:HEALTH AWARENESS SERVICES OF CENTRAL MA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZLOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-756-7123
Mailing Address - Street 1:405 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-1270
Mailing Address - Country:US
Mailing Address - Phone:508-756-7123
Mailing Address - Fax:
Practice Address - Street 1:155 UNION ST
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-1228
Practice Address - Country:US
Practice Address - Phone:508-485-4772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9749497Medicaid