Provider Demographics
NPI:1871578880
Name:DIVERSIFIED COMMUNITY SERVICES
Entity type:Organization
Organization Name:DIVERSIFIED COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR PRACTICE MANAGEMENT & SUPP
Authorized Official - Prefix:MS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-748-9339
Mailing Address - Street 1:PO BOX 686
Mailing Address - Street 2:DIVERSIFIED COMMUNITY SERVICES
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-0686
Mailing Address - Country:US
Mailing Address - Phone:508-595-0531
Mailing Address - Fax:508-829-5367
Practice Address - Street 1:384 HIGH ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-4915
Practice Address - Country:US
Practice Address - Phone:413-536-7385
Practice Address - Fax:413-533-6957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM15509OtherBLUE CROSS
MA9767398Medicaid
MA9767398Medicaid