Healthcare Provider Details

I. General information

NPI: 1376673111
Provider Name (Legal Business Name): THE GERIATRIC AUTHORITY OF HOLYOKE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 LOWER WESTFIELD RD
HOLYOKE MA
01040-2747
US

IV. Provider business mailing address

45 LOWER WESTFIELD RD
HOLYOKE MA
01040-2747
US

V. Phone/Fax

Practice location:
  • Phone: 413-536-8110
  • Fax: 413-538-9875
Mailing address:
  • Phone: 413-536-8110
  • Fax: 413-538-9875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateMA

VIII. Authorized Official

Name: MR. CHRISTOPHER GERARD RONDEAU
Title or Position: CONTROLLER
Credential:
Phone: 413-536-8110