Healthcare Provider Details
I. General information
NPI: 1578491205
Provider Name (Legal Business Name): THEODOSS MULTI SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
720 CENTRE ST STE 2B
BROCKTON MA
02302-3366
US
IV. Provider business mailing address
720 CENTRE ST STE 2B
BROCKTON MA
02302-3366
US
V. Phone/Fax
- Phone: 508-545-7858
- Fax:
- Phone: 508-545-7858
- Fax: 339-244-0692
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171R00000X |
| Taxonomy | Interpreter |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1744G0900X |
| Taxonomy | Graphics Designer |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MALIDA
THEODORE
Title or Position: PRESIDENT
Credential:
Phone: 508-545-7858