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General NPI Number Information
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NPI Number | 1083455828
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Entity Type | Organization
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Legal Business Name | JUST ROOTS INC.
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 34 GLENBROOK DR APT 1B
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City | GREENFIELD
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State | MA
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Zip | 01301-9722
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Country | US
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Telephone | 413-325-8969
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Fax |
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Provider Business Mailing Address
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Address Line | 34 GLENBROOK DR APT 1B
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City | GREENFIELD
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State | MA
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Zip | 01301-9722
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Country | US
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Telephone | 413-325-8969
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | JOSHUA DAVID FALLER
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Credential |
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Telephone | 413-325-8969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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