Provider Demographics
NPI:1861646564
Name:COMMUNITAS, INC.
Entity Type:Organization
Organization Name:COMMUNITAS, INC.
Other - Org Name:LIFE CHOICES NORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO & CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:COTE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:781-587-2220
Mailing Address - Street 1:60 D AUDUBON ROAD
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880
Mailing Address - Country:US
Mailing Address - Phone:781-587-2200
Mailing Address - Fax:781-587-1362
Practice Address - Street 1:800 CUMMINGS CENTER
Practice Address - Street 2:SUITE 166S
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915
Practice Address - Country:US
Practice Address - Phone:978-279-2100
Practice Address - Fax:978-279-2105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-07
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1300814Medicaid