Provider Demographics
NPI:1255481107
Name:NORTH SUFFOLK COMMUNITY SERVICES INC.
Entity type:Organization
Organization Name:NORTH SUFFOLK COMMUNITY SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JUDI
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMOINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-912-7910
Mailing Address - Street 1:301 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-2807
Mailing Address - Country:US
Mailing Address - Phone:617-889-4860
Mailing Address - Fax:617-889-4635
Practice Address - Street 1:130 CONDOR ST
Practice Address - Street 2:
Practice Address - City:EAST BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-1305
Practice Address - Country:US
Practice Address - Phone:617-569-6560
Practice Address - Fax:617-569-1856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACERTIFIED BY DPH261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA612900OtherHARVARD PILGRIM
MAEI0002OtherBLUE CROSS OF MA
42317215002OtherTRICARE-CHAMPUS
MA0006844OtherNEIGHBORHOOD HEALTH PLAN
CT821870OtherAETNA-US HEALTHCARE
MA99625101OtherNETWORK HEALTH
CT3836587OtherCIGNA
MA708502OtherTUFTS HEALTH PLAN
MA00000005443OtherBMC HEALTHNET-EI
MA1800515Medicaid