NPIMap

Organization Active NPI

Interim House Inc

  • Substance Abuse Rehabilitation Facility
  • Dorchester, MA
National Provider Identifier
1508136177
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
1697 Issued in MA
Legal business name
INTERIM HOUSE INC
Practice address
62 Waldeck St
Dorchester, MA 02124-1329
Phone
(617) 265-2636
NPI assigned
Jan 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Authorized official

Name
Mr. Robert Ralph Madaruso, LADC1
Title
Clinical Director
Phone
(617) 265-2636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 1697 MA Primary

Addresses

Primary practice location

62 Waldeck St
Dorchester, MA 02124-1329

Mailing address

62 Waldeck St
Dorchester, MA 02124-1329
Phone (617) 265-2636

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326326400000",
    "number": "1508136177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 WALDECK ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021241329",
            "telephone_number": "617-265-2636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 WALDECK ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021241329",
            "telephone_number": "617-265-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERIM HOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-12",
        "last_updated": "2012-01-12",
        "status": "A",
        "authorized_official_last_name": "MADARUSO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "RALPH",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "617-265-2636",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LADC1"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MA",
            "license": "1697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.