NPIMap

Organization Active NPI

Justice Resource Institute

  • Community/Behavioral Health Agency
  • Boston, MA
National Provider Identifier
1285023655
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
JUSTICE RESOURCE INSTITUTE
Practice address
3 Pickering Avenue # 1
Boston, MA 02119-2225
Phone
(617) 987-5977
NPI assigned
Jan 22, 2015
Last updated
Jan 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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

Authorized official

Name
Mr. Kenneth Jarrell Waller
Title
Therapeutic Mentor
Phone
(617) 987-5977

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

3 Pickering Avenue # 1
Boston, MA 02119-2225

Mailing address

3 Pickering Ave # 1
Boston, MA 02119-2225
Phone (617) 987-5977

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

NPI Registry JSON

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421884800000",
    "number": "1285023655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 PICKERING AVE # 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021192225",
            "telephone_number": "617-987-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 PICKERING AVENUE # 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021192225",
            "telephone_number": "617-987-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTICE RESOURCE INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-22",
        "last_updated": "2015-01-22",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "JARRELL",
        "authorized_official_title_or_position": "THERAPEUTIC MENTOR",
        "authorized_official_telephone_number": "617-987-5977",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; 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.