Marillac Residence, Inc

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

MARILLAC RESIDENCE, INC

Practice address

125 Oakland St
Wellesley Hills, MA 02481-5338

Phone

(781) 997-1124

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Helen Shknevsky

Title

Director of Fiscal Services

Phone

(781) 997-1124

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972630317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 OAKLAND ST",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024815338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 OAKLAND ST",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024815338",
            "telephone_number": "781-997-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILLAC RESIDENCE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHKNEVSKY",
        "authorized_official_first_name": "HELEN",
        "authorized_official_title_or_position": "DIRECTOR OF FISCAL SERVICES",
        "authorized_official_telephone_number": "781-997-1124"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5508525",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Voluntary or Charitable Agency in Wellesley Hills, MA
• Providers in Wellesley Hills, MA by specialty
• Voluntary or Charitable Agency in Massachusetts

• 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.