Provider Demographics
NPI:1184751422
Name:CITY OF HOLYOKE
Entity type:Organization
Organization Name:CITY OF HOLYOKE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXEC DIR OF FINANCE AND OPERATIONS
Authorized Official - Prefix:MISS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAVANAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-534-2000
Mailing Address - Street 1:57 SUFFOLK ST
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-5015
Mailing Address - Country:US
Mailing Address - Phone:413-534-2000
Mailing Address - Fax:413-534-2172
Practice Address - Street 1:57 SUFFOLK ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-5015
Practice Address - Country:US
Practice Address - Phone:413-534-2000
Practice Address - Fax:413-534-2172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1953214Medicaid