Provider Demographics
NPI:1295870673
Name:CITIZENS FOR CITIZENS, INC.
Entity type:Organization
Organization Name:CITIZENS FOR CITIZENS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:508-675-2882
Mailing Address - Street 1:337 HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5421
Mailing Address - Country:US
Mailing Address - Phone:508-675-2882
Mailing Address - Fax:508-324-7508
Practice Address - Street 1:337 HANOVER ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5421
Practice Address - Country:US
Practice Address - Phone:508-675-2882
Practice Address - Fax:508-324-7508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000024360OtherBOSTON HEALTHNET
MA1600109Medicaid
MA763436OtherTUFTS HEALTH PLAN