Healthcare Provider Details

I. General information

NPI: 1023320702
Provider Name (Legal Business Name): CLINICAL & SUPPORT OPTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2010
Last Update Date: 07/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 MAPLE ST STE 325
SPRINGFIELD MA
01103-2215
US

IV. Provider business mailing address

130 MAPLE ST SUITE 325
SPRINGFIELD MA
01103-2202
US

V. Phone/Fax

Practice location:
  • Phone: 413-737-9544
  • Fax: 413-737-4455
Mailing address:
  • Phone: 413-737-9544
  • Fax: 413-737-4455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: NELLIE RODRIGUEZ
Title or Position: OFFICE MANAGER
Credential:
Phone: 413-737-9544