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General NPI Number Information
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NPI Number | 1194097949
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Entity Type | Organization
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Legal Business Name | KIT CLARK SENIOR SERVICES, INC
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Dates
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Enumeration Date | 02/08/2012
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 645 WASHINGTON ST
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City | DORCHESTER
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State | MA
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Zip | 02124-3510
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Country | US
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Telephone | 617-474-1272
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Fax |
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Provider Business Mailing Address
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Address Line | 66 CANAL ST
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City | BOSTON
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State | MA
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Zip | 02114-2002
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Country | US
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Telephone | 617-371-3000
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Fax |
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Authorized Official
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Title or Position | SVP CFO FINANCE
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Name | KERRY HORGOS
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Credential |
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Telephone | 617-371-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State | MA
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