Healthcare Provider Details

I. General information

NPI: 1891929451
Provider Name (Legal Business Name): UCP OF WESTERN MASSACHUSETTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2009
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 WEST ST
PITTSFIELD MA
01201-5703
US

IV. Provider business mailing address

208 WEST ST
PITTSFIELD MA
01201-5703
US

V. Phone/Fax

Practice location:
  • Phone: 413-442-1562
  • Fax: 413-499-4077
Mailing address:
  • Phone: 413-442-1562
  • Fax: 413-499-4077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateMA

VIII. Authorized Official

Name: RANDALL KINNAS
Title or Position: CEO
Credential:
Phone: 413-442-1562