Provider Demographics
NPI:1295944353
Name:PROTESTANT GUILD FOR HUMAN SERVICES, INC.
Entity type:Organization
Organization Name:PROTESTANT GUILD FOR HUMAN SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SOWYRDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-893-6000
Mailing Address - Street 1:411WAVERLY OAKS RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02452-8468
Mailing Address - Country:US
Mailing Address - Phone:781-893-6000
Mailing Address - Fax:781-893-1171
Practice Address - Street 1:411WAVERLY OAKS RD
Practice Address - Street 2:SUITE 104
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02452-8468
Practice Address - Country:US
Practice Address - Phone:781-893-6000
Practice Address - Fax:781-893-1171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children