Provider Demographics
NPI:1740404763
Name:ELDER SERVICES OF BERKSHRE COUNTY INC.
Entity Type:Organization
Organization Name:ELDER SERVICES OF BERKSHRE COUNTY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-499-0524
Mailing Address - Street 1:66 WENDELL AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-6306
Mailing Address - Country:US
Mailing Address - Phone:413-499-0524
Mailing Address - Fax:413-445-5395
Practice Address - Street 1:66 WENDELL AVE
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6306
Practice Address - Country:US
Practice Address - Phone:413-499-0524
Practice Address - Fax:413-445-5395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1948547Medicaid