Look up the most recent NPI and PECOS records

Travis Corporation

(<Unavail>)

Counselor

Behavioral Health & Social Service Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Travis Corporation does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1659302396
Provider Type
Organization
Full Name
Travis Corporation
Other Name
<Unavail>

Subpart
No
Enumeration Date
7/5/2006
Last Updated
2/9/2009

Contact Information

Practice Location

1705 Columbus Ave., Roxbury, MA 02119

(617) 516-5150

(617) 442-6915

Mailing Location

1705 Columbus Ave, Roxbury, MA 02119

(617) 516-5150

(617) 442-6915

Authorized Official

Bird, Bruce L (Ceo)

(617) 441-1770

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License 4211 Massachusetts

Travis Corporation

(<Unavail>)

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Hughes Pearson, Ajanay

Zhang, Weiling

Williams, Linda

Jones, Keyana

De Zarraga, Christina

James, Patricka K

Davis, Donna M

Yusif, Michelangela

Mendygral, Hannah

Gregg, Paul