Provider Demographics
NPI:1972830958
Name:JUSTICE RESOURCE INSTITUTE, INC.
Entity Type:Organization
Organization Name:JUSTICE RESOURCE INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:POND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-559-4900
Mailing Address - Street 1:160 GOULD ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-2313
Mailing Address - Country:US
Mailing Address - Phone:781-559-4900
Mailing Address - Fax:781-559-4901
Practice Address - Street 1:162 HOWARD ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8311
Practice Address - Country:US
Practice Address - Phone:508-872-0669
Practice Address - Fax:508-879-4140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-11
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110024430EMedicaid
MA1300539Medicaid