NPIMap

Organization Active NPI

Real Change Inc

  • Community/Behavioral Health Agency
  • Mattapan, MA
National Provider Identifier
1083948541
Registry record updated Dec 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
214156 Issued in MA
Legal business name
REAL CHANGE INC
Practice address
189 Ruskindale Rd
Mattapan, MA 02126-1653
Phone
(617) 223-7324
NPI assigned
Sep 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2009

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

Authorized official

Name
Mr. Derrick Ervin Harper, MSW,LCSW
Title
President/Ceo
Phone
(617) 223-7324

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 214156 MA
Community/Behavioral Health Agency 251S00000X 214156 MA Primary
In Home Supportive Care Agency 253Z00000X 214156 MA

Addresses

Primary practice location

189 Ruskindale Rd
Mattapan, MA 02126-1653

Mailing address

189 Ruskindale Rd
Mattapan, MA 02126-1653

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260144000000",
    "number": "1083948541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 RUSKINDALE RD",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021261653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 RUSKINDALE RD",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021261653",
            "telephone_number": "617-223-7324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REAL CHANGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-30",
        "last_updated": "2009-12-07",
        "status": "A",
        "authorized_official_last_name": "HARPER",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "ERVIN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "617-223-7324",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW,LCSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MA",
            "license": "214156",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MA",
            "license": "214156",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MA",
            "license": "214156",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattapan, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; 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.