Healthcare Provider Details

I. General information

NPI: 1093022139
Provider Name (Legal Business Name): YOU INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2010
Last Update Date: 09/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

172 LINCOLN ST
WORCESTER MA
01605-3750
US

IV. Provider business mailing address

172 LINCOLN ST
WORCESTER MA
01605-3750
US

V. Phone/Fax

Practice location:
  • Phone: 508-770-0511
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. ZACHARY WORDEN
Title or Position: INTERN
Credential:
Phone: 508-770-0511