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Organization

RIVERSIDE COMMUNITY CARE

Active
Other names
Riverside Community Care
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARSHA MEDALIE (EXECUTIVE VICE PRES.)
(781) 320-5328
Entity
Organization

Contact information

Practice address
255 HIGHLAND AVE, NEEDHAM, MA 02494-3023
(781) 449-1884
Mailing address
450 WASHINGTON ST, SUITE 201, DEDHAM, MA 02026-4455
(781) 329-0909
(781) 329-2631

Taxonomy

Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0007559
NHP
05
1802704
MA
01
617939
HPHC
01
715687
TUFTS EI
01
EI0028
BCBSMA
Enumeration date
04/13/2007
Last updated
05/01/2013
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