NPIMap

Organization Active NPI

Wayside Youth and Family Support Netwrok

  • Community/Behavioral Health Agency
  • Waltham, MA
National Provider Identifier
1942423165
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
WAYSIDE YOUTH AND FAMILY SUPPORT NETWROK
Practice address
118 Central St
Waltham, MA 02453-5465
Phone
(781) 891-0556
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Michelle S Henriquez, B.A
Title
Youth Support Worker
Phone
(781) 891-0556

Specialties & licenses 1

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

Addresses

Primary practice location

118 Central St
Waltham, MA 02453-5465

Mailing address

118 Central St
Waltham, MA 02453-5465
Phone (781) 891-0556

National Provider Directory

National Provider Directory
Tax ID family
Wayside Youth and Family Support Network8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942423165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 CENTRAL ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024535465",
            "telephone_number": "781-891-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 CENTRAL ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024535465",
            "telephone_number": "781-891-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYSIDE YOUTH AND FAMILY SUPPORT NETWROK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENRIQUEZ",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "YOUTH SUPPORT WORKER",
        "authorized_official_telephone_number": "781-891-0556",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "B.A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.