Basic Information
| Provider Information | |||||||||
| NPI: | 1710379474 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARING HEALTH CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1049 MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137391100 | ||||||||
| FaxNumber: | 4137319919 | ||||||||
| Practice Location | |||||||||
| Address1: | 417 LIBERTY ST | ||||||||
| Address2: | BHN-SITE | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011043736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4133019463 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/04/2015 | ||||||||
| LastUpdateDate: | 03/04/2015 | ||||||||
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| AuthorizedOfficialLastName: | BARBER | ||||||||
| AuthorizedOfficialFirstName: | TANIA | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 4136931007 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0400X | 4940 | MA | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
ID Information
| ID | Type | State | Issuer | Description | M16151 | 01 | MA | BCBSMA | OTHER | MA0061729 | 01 | MA | STATE CONTROLLED SUBSTANCE REGISTRATION | OTHER | 110028120 | 05 | MA | MEDICAID | 181 | 01 | MA | NHP GROUP # | OTHER | FC3831496 | 01 | MA | FEDERAL DEA CONTROLLED SUBSTANCE REGISTRATION | OTHER |