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General NPI Number Information
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NPI Number | 1740081579
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Entity Type | Organization
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Legal Business Name | UCP OF WESTERN MASSACHUSETTS INC
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 75 S CHURCH ST # 201
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City | PITTSFIELD
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State | MA
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Zip | 01201-6157
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Country | US
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Telephone | 413-442-1562
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Fax | 413-224-9281
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Provider Business Mailing Address
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Address Line | 208 WEST ST
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City | PITTSFIELD
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State | MA
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Zip | 01201-5703
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Country | US
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Telephone | 413-442-1562
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Fax | 413-224-9281
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Authorized Official
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Title or Position | CEO
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Name | RANDALL KINNAS
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Credential |
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Telephone | 413-442-1562
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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