Healthcare Provider Details

I. General information

NPI: 1467556928
Provider Name (Legal Business Name): FAMILY SERVICES ORGANIZATION OF WORCESTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

799 W BOYLSTON ST
WORCESTER MA
01606-3071
US

IV. Provider business mailing address

81 HOPE AVE
WORCESTER MA
01603-2212
US

V. Phone/Fax

Practice location:
  • Phone: 508-756-4646
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL MATTHEWS
Title or Position: SR VP OF BUSINESS & FINANCE
Credential:
Phone: 508-983-2901