NPIMap

Organization Active NPI

Eliot Community Human Services, Inc.

Doing business as Community Support Program

  • Community/Behavioral Health Agency
  • Lexington, MA
National Provider Identifier
1396435624
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ELIOT COMMUNITY HUMAN SERVICES, INC.
Doing business as
Community Support Program
Practice address
125 Hartwell Ave
Lexington, MA 02421-3100
Phone
(781) 861-0890
NPI assigned
May 10, 2023
Last updated
May 10, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ELIOT COMMUNITY HUMAN SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Authorized official

Name
Leona Walton
Title
Billing Support Analyst
Phone
(781) 861-0890

Specialties & licenses 1

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

Addresses

Primary practice location

125 Hartwell Ave
Lexington, MA 02421-3100

Mailing address

125 Hartwell Ave
Lexington, MA 02421-3100
Phone (781) 861-0890

Other identifiers 1

IdentifierTypeStateIssuer
110027776MedicaidMA

Other names 1

  • Community Support Program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eliot Community Mental20 organizations share this tax ID, including this one
Part of
Eliot Community Mental

Other organizations with this tax ID 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683676800000",
    "number": "1396435624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 HARTWELL AVE",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024213100",
            "telephone_number": "781-861-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 HARTWELL AVE",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024213100",
            "telephone_number": "781-861-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIOT COMMUNITY HUMAN SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELIOT COMMUNITY HUMAN SERVICES, INC.",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "LEONA",
        "authorized_official_title_or_position": "BILLING SUPPORT ANALYST",
        "authorized_official_telephone_number": "781-861-0890"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110027776",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Support Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; 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.