Provider Demographics
NPI:1538409784
Name:SOMERVILLE HOMELESS COALITION
Entity type:Organization
Organization Name:SOMERVILLE HOMELESS COALITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LIBBY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:617-623-6111
Mailing Address - Street 1:1 DAVIS SQ
Mailing Address - Street 2:BASEMENT LEVEL
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2904
Mailing Address - Country:US
Mailing Address - Phone:617-623-6111
Mailing Address - Fax:617-776-7165
Practice Address - Street 1:1 DAVIS SQ
Practice Address - Street 2:BASEMENT LEVEL
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2904
Practice Address - Country:US
Practice Address - Phone:617-623-6111
Practice Address - Fax:617-776-7165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management