NPIMap

Organization Active NPI

Greater Waltham Arc, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Waltham, MA
National Provider Identifier
1043359797
Registry record updated Oct 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
GREATER WALTHAM ARC, INC.
Practice address
56 Chestnut St
Waltham, MA 02453-4433
Phone
(781) 899-1344
Fax
(781) 899-2197
NPI assigned
Feb 6, 2007
Organization subpart
Yes
Parent organization
GREATER WALTHAM ARC, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 28, 2011

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

Authorized official

Name
Dr. Roslynn Rubin, ED. D
Title
Executive Director
Phone
(781) 899-1344

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X MA Primary

Addresses

Primary practice location

56 Chestnut St
Waltham, MA 02453-4433

Mailing address

56 Chestnut St
Waltham, MA 02453-4433
Phone (781) 899-1344

Other identifiers 2

IdentifierTypeStateIssuer
110027946AMedicaidMA
1319787MedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
Greater Waltham Arc Inc3 organizations share this tax ID, including this one
Part of
Greater Waltham Arc Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319760000000",
    "number": "1043359797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 CHESTNUT ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024534433",
            "telephone_number": "781-899-1344",
            "fax_number": "781-899-2197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 CHESTNUT ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024534433",
            "telephone_number": "781-899-1344",
            "fax_number": "781-899-2197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER WALTHAM ARC, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREATER WALTHAM ARC, INC.",
        "enumeration_date": "2007-02-06",
        "last_updated": "2011-10-28",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "ROSLYNN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "781-899-1344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED. D"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110027946A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1319787",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; 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.