Provider Demographics
NPI:1720208770
Name:OPEN SKY COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:OPEN SKY COMMUNITY SERVICES, INC.
Other - Org Name:ALTERNATIVES UNLIMITED INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO & EVP
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENVENUTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-318-7405
Mailing Address - Street 1:4 MANN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602
Mailing Address - Country:US
Mailing Address - Phone:508-318-7350
Mailing Address - Fax:508-234-1333
Practice Address - Street 1:54 DOUGLAS ROAD
Practice Address - Street 2:
Practice Address - City:WHITINSVILLE
Practice Address - State:MA
Practice Address - Zip Code:01588
Practice Address - Country:US
Practice Address - Phone:508-318-7350
Practice Address - Fax:508-234-1333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1905198Medicaid