Old Colony YMCA Wellness Services, Inc.

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

OLD COLONY YMCA WELLNESS SERVICES, INC.

Practice address

445 Central St
Stoughton, MA 02072-1900

Phone

(781) 341-2016

NPI assigned

Oct 8, 2024

Organization subpart

Yes

Parent organization

OLD COLONY YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.As reported in NPPES

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

Authorized official

Name

Mr. Charles Clifford

Title

President & Ceo

Phone

(508) 897-1220

Specialties & licenses 5

Addresses

Tax ID family

Old Colony YMCA Wellness Services Inc3 organizations share this tax ID, including this one

Part of

Old Colony Y

Other organizations with this tax ID 2

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

• Old Colony YMCA Wellness Services, Inc.

  • Health Educator
  • Brockton, MA
  • NPI 1497385314
  NPD tax ID
• Old Colony YMCA Wellness Services, Inc.

  • Case Management Agency
  • Stoughton, MA
  • NPI 1598587149
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Old Colony Young Men'S Christian Association, Inc.

  • Clinical Psychologist
  • Brockton, MA
  • NPI 1366506677
  NPPES parent name

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1497574206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015340",
            "telephone_number": "508-583-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 CENTRAL ST",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020721900",
            "telephone_number": "781-341-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD COLONY YMCA WELLNESS SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OLD COLONY YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "CLIFFORD",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "508-897-1220",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chinazo Jamie Odunze
• John Kyoung Oh, PHARMD
• Ojehealth LLC
• Ifeoma Okeke
• Old Colony Adult Day Health Care, Inc.
• Old Colony YMCA Wellness Services, Inc.
• Neil W Oliwa, MD
• Sheryl Olshin, LICSW
• Omega Homecare Systems Inc
• Abumchukwu Onujiogu

• Public Health or Welfare Agency in Stoughton, MA
• Providers in Stoughton, MA by specialty
• Public Health or Welfare Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.