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General NPI Number Information
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NPI Number | 1033409057
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Entity Type | Organization
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Legal Business Name | FIRST RESPONSE CLINICAL SERVICES, LLC
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 20 HOPE AVE SUITE 204
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City | WALTHAM
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State | MA
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Zip | 02453-2721
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Country | US
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Telephone | 866-604-0911
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Fax | 508-435-0977
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Provider Business Mailing Address
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Address Line | 364 WOOD ST
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City | HOPKINTON
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State | MA
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Zip | 01748-1026
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Country | US
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Telephone | 508-259-1209
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Fax | 508-435-0977
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARYBETH ANN MILLS
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Credential | REGISTERED NURSE
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Telephone | 508-259-1209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | RN230945
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License Number State | MA
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