Provider Demographics
NPI:1720580822
Name:LATIN AMERICAN HEALTH ALLIANCE OF CENTRAL MASSACHUSETTS, INC.
Entity Type:Organization
Organization Name:LATIN AMERICAN HEALTH ALLIANCE OF CENTRAL MASSACHUSETTS, INC.
Other - Org Name:HECTOR REYES HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-459-1801
Mailing Address - Street 1:27 VERNON ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01610-1919
Mailing Address - Country:US
Mailing Address - Phone:508-459-1801
Mailing Address - Fax:508-459-1808
Practice Address - Street 1:27 VERNON ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01610-1919
Practice Address - Country:US
Practice Address - Phone:508-459-1801
Practice Address - Fax:508-459-1808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management