NPI 1003039322
Commonwealth of Massachusetts
Practice location
- Address
- 324 R Clark Street, Worcester, MA 01606
- Phone
- (508) 792-6200
- Mailing address
- 40th Broad Street 4th Floor, Boston, MA 02109
Authorised official
- Name
- Dylan Lattimore
- Title
- Deputy Commissioner for Administrat
- Phone
- (857) 408-0675
Registered specialties
Case Management Agency
Primary
Registry record
- NPI
- 1003039322
- Entity type
- Organization
- NPI issued
- 11 Apr 2007
- Record last updated
- 19 Mar 2026
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.