Provider Demographics
NPI:1760516090
Name:CITY OF ATTLEBORO HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:CITY OF ATTLEBORO HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:JOYAL
Authorized Official - Last Name:OBRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:508-223-2222
Mailing Address - Street 1:77 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2334
Mailing Address - Country:US
Mailing Address - Phone:508-223-2222
Mailing Address - Fax:774-203-1877
Practice Address - Street 1:77 PARK ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2334
Practice Address - Country:US
Practice Address - Phone:508-223-2222
Practice Address - Fax:774-203-1877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230449163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty