Healthcare Provider Details

I. General information

NPI: 1649367939
Provider Name (Legal Business Name): 21ST CENTURY MANAGEMENT SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 03/25/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 N MAIN ST
RANDOLPH MA
02368-4180
US

IV. Provider business mailing address

402 N MAIN ST
RANDOLPH MA
02368-4180
US

V. Phone/Fax

Practice location:
  • Phone: 781-828-0221
  • Fax:
Mailing address:
  • Phone: 781-828-0221
  • Fax: 781-828-8555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberR03249
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. JUDITH JOSEPH
Title or Position: OWNER/PRESIDENT
Credential: MSM
Phone: 781-828-0221