Provider Demographics
NPI:1720731037
Name:FIDELIS COMMUNITY SERVICES INC.
Entity Type:Organization
Organization Name:FIDELIS COMMUNITY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIUD
Authorized Official - Middle Name:
Authorized Official - Last Name:MAINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-484-0337
Mailing Address - Street 1:321 BILLERICA RD STE 8
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-4100
Mailing Address - Country:US
Mailing Address - Phone:978-484-0337
Mailing Address - Fax:978-484-0337
Practice Address - Street 1:321 BILLERICA RD STE 8
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-4100
Practice Address - Country:US
Practice Address - Phone:978-484-0337
Practice Address - Fax:978-484-0337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253J00000XAgenciesFoster Care Agency
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child