Greater Waltham Arc, Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

GREATER WALTHAM ARC, INC.

Practice address

56 Chestnut St
Waltham, MA 02453-4433

Phone

(781) 899-1344

Fax

(781) 899-2197

NPI assigned

Nov 16, 2011

Organization subpart

Yes

Parent organization

GREATER WALTHAM ARC, INC.As reported in NPPES

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

Authorized official

Name

John Wiswall

Title

Chief Financial Officer

Phone

(781) 899-1344

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Greater Waltham Arc Inc3 organizations share this tax ID, including this one

Part of

Greater Waltham Arc Inc

Other organizations with this tax ID 2

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

• Greater Waltham Arc, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Waltham, MA
  • NPI 1043359797
  NPD tax ID
• Greater Waltham Association for Retarded Citizens, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Waltham, MA
  • NPI 1629296462
  NPD tax ID

Locations

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321401600000",
    "number": "1629355847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 CHESTNUT ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024534433",
            "telephone_number": "781-899-1344",
            "fax_number": "781-899-2197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 CHESTNUT ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024534433",
            "telephone_number": "781-899-1344",
            "fax_number": "781-899-2197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER WALTHAM ARC, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREATER WALTHAM ARC, INC.",
        "enumeration_date": "2011-11-16",
        "last_updated": "2011-11-16",
        "status": "A",
        "authorized_official_last_name": "WISWALL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "781-899-1344"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110027946D",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Joseph Grady, M.D.,
• Lora Grass
• Erik Michael Grau, MFA, BA
• Carolyn Matthews Graybeal, ED.D.
• Greater Waltham Arc, Inc.
• Greater Waltham Association for Retarded Citizens, Inc.
• Ashley Greco
• Frances Ellen Green, LICSW
• James Mark Greenblatt, M.D
• Peter Tebet Greenspan, MD

• Adult Care Home Facility in Waltham, MA
• Providers in Waltham, MA by specialty
• Adult Care Home Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; 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.