Healthcare Provider Details

I. General information

NPI: 1134929102
Provider Name (Legal Business Name): SOUTH MIDDLESEX OPPORTUNITY COUNCIL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2025
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 BISHOP ST
FRAMINGHAM MA
01702-8323
US

IV. Provider business mailing address

7 BISHOP ST
FRAMINGHAM MA
01702-8323
US

V. Phone/Fax

Practice location:
  • Phone: 774-346-4255
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: SUSAN GENTILI
Title or Position: CEO
Credential:
Phone: 508-620-2419