Provider Demographics
NPI:1982914610
Name:ELIOT COMMUNITY HUMAN SERVICES
Entity Type:Organization
Organization Name:ELIOT COMMUNITY HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF YOUTH PROGRAMING
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAULT
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:781-861-0890
Mailing Address - Street 1:186 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420
Mailing Address - Country:US
Mailing Address - Phone:781-861-0890
Mailing Address - Fax:781-861-0899
Practice Address - Street 1:186 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420
Practice Address - Country:US
Practice Address - Phone:781-861-0890
Practice Address - Fax:781-861-0899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS61428188253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care