Healthcare Provider Details

I. General information

NPI: 1336569193
Provider Name (Legal Business Name): CENTER FOR HUMAN DEVELOPMENT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2014
Last Update Date: 04/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 BIRNIE AVE
SPRINGFIELD MA
01107-1104
US

IV. Provider business mailing address

332 BIRNIE AVE
SPRINGFIELD MA
01107-1104
US

V. Phone/Fax

Practice location:
  • Phone: 413-733-6624
  • Fax:
Mailing address:
  • Phone: 413-733-6624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateMA

VIII. Authorized Official

Name: JAMES GOODWIN
Title or Position: PRESIDENT CEO
Credential:
Phone: 413-439-2247