Organization
UPHAM'S CORNER HEALTH COMMITTEE, INC.
Active
Other names
Upham's Elder Service Plan
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAGDEEP TRIVEDI (CEO)
(617) 740-8131
Entity
Organization
Contact information
Practice address
1140 DORCHESTER AVE, DORCHESTER, MA 02125-3305
(617) 288-0970
(617) 474-0757
Mailing address
500 COLUMBIA RD, DORCHESTER, MA 02125-2322
(617) 288-0970
(617) 282-8625
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1803344
—
MA
Enumeration date
10/27/2006
Last updated
07/12/2017
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