Provider Demographics
NPI:1851396014
Name:ARC WORCESTER CENTER, L.P.
Entity Type:Organization
Organization Name:ARC WORCESTER CENTER, L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:COLLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMAISTRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-250-3640
Mailing Address - Street 1:300 GROVE STREET
Mailing Address - Street 2:
Mailing Address - City:WORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3908
Mailing Address - Country:US
Mailing Address - Phone:508-754-0700
Mailing Address - Fax:501-831-9989
Practice Address - Street 1:300 GROVE ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3908
Practice Address - Country:US
Practice Address - Phone:508-754-0700
Practice Address - Fax:508-831-9989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4361261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1210769Medicaid
MDM77010OtherBLUE CROSS BLUE SHIELD
MDM77010OtherBLUE CROSS BLUE SHIELD