Healthcare Provider Details

I. General information

NPI: 1962700963
Provider Name (Legal Business Name): UNITED CHURCH HOMES OF READING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2011
Last Update Date: 03/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 NORTH AVE # 18
WAKEFIELD MA
01880-1322
US

IV. Provider business mailing address

50 BAY STATE RD
READING MA
01867-1962
US

V. Phone/Fax

Practice location:
  • Phone: 781-224-2800
  • Fax:
Mailing address:
  • Phone: 781-944-6262
  • Fax: 781-944-7043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. JACQUELINE DALE CARSON
Title or Position: CEO
Credential:
Phone: 781-929-9588