Mama Doris Foundation Inc

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

MAMA DORIS FOUNDATION INC

Practice address

360 W Boylston St RM 215
West Boylston, MA 01583-2368

Phone

(774) 261-8482

Fax

(774) 261-8480

NPI assigned

Jul 6, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Maggie Jentzen

Title

Administrator

Phone

(774) 261-8482

Specialties & licenses 1

Addresses

Other names 1

• Mama Doris Foundation Inc Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691971200000",
    "number": "1003594417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W BOYLSTON ST RM 215",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015832368",
            "telephone_number": "774-261-8482",
            "fax_number": "774-261-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W BOYLSTON ST RM 215",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015832368",
            "telephone_number": "774-261-8482",
            "fax_number": "774-261-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAMA DORIS FOUNDATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A",
        "authorized_official_last_name": "JENTZEN",
        "authorized_official_first_name": "MAGGIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "774-261-8482"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mama Doris Foundation Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lutz Child and Family Associates, P.C.
• John Carl Lutz, PSY.D.
• Julie Ellen Lysiak, RN MS CS
• Kaitlin Mackay, BCBA
• Stephanie Malo
• Emily Mandara
• John Bowler Manning Jr., DC
• Alexandra Catherine Mardirosian
• Richard Charles Martino, OD
• Kimberly Mastis, M.D.

• In Home Supportive Care Agency in West Boylston, MA
• Providers in West Boylston, MA by specialty
• In Home Supportive Care Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.