Provider Demographics
| NPI: | 1821129982 |
|---|---|
| Name: | MAB COMMUNITY SERVICES, INC |
| Entity type: | Organization |
| Organization Name: | MAB COMMUNITY SERVICES, INC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | ADMIN |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | REBECCA |
| Authorized Official - Middle Name: | L |
| Authorized Official - Last Name: | ASHE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 508-735-6241 |
| Mailing Address - Street 1: | 200 IVY ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | BROOKLINE |
| Mailing Address - State: | MA |
| Mailing Address - Zip Code: | 02446-3907 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 617-738-5110 |
| Mailing Address - Fax: | 617-738-1247 |
| Practice Address - Street 1: | 799 W BOYLSTON ST |
| Practice Address - Street 2: | SUITE 7 |
| Practice Address - City: | WORCESTER |
| Practice Address - State: | MA |
| Practice Address - Zip Code: | 01606-3071 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 508-854-0700 |
| Practice Address - Fax: | 508-854-0733 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2007-03-08 |
| Last Update Date: | 2024-11-10 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 225400000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner | Group - Multi-Specialty | |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 225XF0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Feeding, Eating & Swallowing | Group - Multi-Specialty |
| No | 225XL0004X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Low Vision | Group - Multi-Specialty |
| No | 225XP0019X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation | Group - Multi-Specialty |
| No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |
| No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
| No | 251E00000X | Agencies | Home Health | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| MA | 110028905B | Medicaid | |
| MA | OG0066 | Other | BCBS |
| MA | OG0066 | Other | BCBS |
