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General NPI Number Information
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NPI Number | 1649917691
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Entity Type | Organization
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Legal Business Name | ALLY ADULT FOSTER CARE LLC
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Dates
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Enumeration Date | 05/19/2022
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 425 UNION ST STE 35
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City | WEST SPRINGFIELD
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State | MA
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Zip | 01089-3485
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Country | US
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Telephone | 413-301-7774
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Fax | 413-363-1724
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Provider Business Mailing Address
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Address Line | 425 UNION ST STE 35
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City | WEST SPRINGFIELD
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State | MA
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Zip | 01089-3485
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Country | US
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Telephone | 413-301-7774
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Fax | 413-363-1724
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Authorized Official
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Title or Position | MANAGER
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Name | BETH K - GRIFFIN
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Credential |
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Telephone | 413-301-7774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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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 | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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