Healthcare Provider Details

I. General information

NPI: 1346366507
Provider Name (Legal Business Name): BAROCO CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 01/19/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 ROANOKE AVE
WEST SPRINGFIELD MA
01089-3710
US

IV. Provider business mailing address

136 WEST STREET UNIT 03
NORTHAMPTON MA
01060
US

V. Phone/Fax

Practice location:
  • Phone: 413-734-9947
  • Fax: 413-734-3038
Mailing address:
  • Phone: 413-378-9019
  • Fax: 877-335-8774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. TIMOTHY RICHERT CLARK
Title or Position: CEO
Credential:
Phone: 413-534-9019