NPIMap

Organization Active NPI

Justice Resource Institute, Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Concord, MA
National Provider Identifier
1134314131
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
490392 Issued in MA
Legal business name
JUSTICE RESOURCE INSTITUTE, INC
Practice address
160 Walden St
Concord, MA 01742-3622
Phone
(978) 369-7611
NPI assigned
Sep 12, 2007
Last updated
Mar 8, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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

Authorized official

Name
Andy Pond, LICSW
Title
President
Phone
(781) 559-4900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 490392 MA Primary

Addresses

Primary practice location

160 Walden St
Concord, MA 01742-3622

Mailing address

160 Gould St
Suite 300
Needham, MA 02494-2313
Phone (781) 559-4900

Other identifiers 1

IdentifierTypeStateIssuer
M18650OtherMABCBS

National Provider Directory

National Provider Directory
Tax ID family
Justice Resource Institute23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Locations

160 Walden St
Concord, MA 01742
Phone (978) 369-7611

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331164800000",
    "number": "1134314131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 GOULD ST",
            "address_2": "SUITE 300",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024942313",
            "telephone_number": "781-559-4900",
            "fax_number": "781-559-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 WALDEN ST",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017423622",
            "telephone_number": "978-369-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTICE RESOURCE INSTITUTE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2012-03-08",
        "status": "A",
        "authorized_official_last_name": "POND",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-559-4900",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "MA",
            "license": "490392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M18650",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; 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.