Organization
COMMONWEALTH OF MASSACHUSETTS
Active
Parent organization
COMMONWEALTH OF MASSACHUSETTS
Other names
Fall River Area Office, DDS Fall River Area Office
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMONWEALTH OF MASSACHUSETTS
Authorized official
DYLAN LATTIMORE (DEPUTY COMMISSIONER FOR ADMINISTRAT)
(857) 408-0675
Entity
Organization
Contact information
Practice address
1 FATHER DEVALLES BLVD, SUITE 203, FALL RIVER, MA 02723
(508) 730-1209
(508) 730-2035
Mailing address
40 BROAD STREET, 4TH FLOOR, BOSTON, MA 02109
(617) 727-5608
(617) 624-7577
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
EXEMPT
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110000085A
—
MA
05
—
1813129
—
MA
Enumeration date
03/16/2007
Last updated
03/19/2026
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