Healthcare Provider Details

I. General information

NPI: 1245361476
Provider Name (Legal Business Name): BERKSHIRE FAMILY AND INDIVIDUAL RESOURCES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

771 CHURCH ST
NORTH ADAMS MA
01247-4109
US

IV. Provider business mailing address

771 CHURCH ST
NORTH ADAMS MA
01247-4109
US

V. Phone/Fax

Practice location:
  • Phone: 413-664-9382
  • Fax: 413-664-6293
Mailing address:
  • Phone: 413-664-9382
  • Fax: 413-664-6293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number1311174
License Number StateMA

VIII. Authorized Official

Name: MR. RICH WEISENFLUE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 413-664-9382