Centro Eden Health Care, Inc.

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

CENTRO EDEN HEALTH CARE, INC.

Practice address

11 Sycamore St
Worcester, MA 01608-2213

Phone

(085) 798-1900

Fax

(508) 798-1914

NPI assigned

Dec 16, 2021

Organization subpart

Yes

Parent organization

CENTRO LAS AMERICASAs reported in NPPES

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

Authorized official

Name

Lisa M. PremoNPI 1598300568

Title

Billing Manager

Phone

(508) 798-1900

Specialties & licenses 1

Addresses

Other names 1

• Centro Eden Health Care, Inc. Other name

Part of

Centro Las Americas

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Premo

  • Mental Health Counselor
  • Worcester, MA
  • NPI 1598300568
  NPD Authorized official

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639612800000",
    "number": "1356000467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SYCAMORE ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016082213",
            "telephone_number": "085-798-1900",
            "fax_number": "508-798-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SYCAMORE ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016082213",
            "telephone_number": "085-798-1900",
            "fax_number": "508-798-1914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO EDEN HEALTH CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRO LAS AMERICAS",
        "enumeration_date": "2021-12-16",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A",
        "authorized_official_last_name": "PREMO",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "508-798-1900"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centro Eden Health Care, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Centro Las Americas
• Centro Las Americas
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• PACE Provider Organization in Worcester, MA
• Providers in Worcester, MA by specialty
• PACE Provider Organization in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.