Healthcare Provider Details

I. General information

NPI: 1548001803
Provider Name (Legal Business Name): WESTERN MASS CARE SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2024
Last Update Date: 06/03/2024
Certification Date: 05/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 MAIN STREET, 8TH FLOOR
SPRINGFIELD MA
01115
US

IV. Provider business mailing address

1500 MAIN STREET, 8TH FLOOR
SPRINGFIELD MA
01115
US

V. Phone/Fax

Practice location:
  • Phone: 413-276-6086
  • Fax:
Mailing address:
  • Phone: 413-276-6086
  • Fax:

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: MS. LOURDES BALESTIER
Title or Position: OWNER/PROGRAM DIRECTOR
Credential:
Phone: 413-276-6086