ZZ-LAKE AVENUE VA CLINIC (3831) INSTITUTION (4)

Name	Value
NAME	ZZ-LAKE AVENUE VA CLINIC
STATE	MASSACHUSETTS
STREET ADDR. 1	55 N. LAKE AVENUE 7TH FLOOR
CITY	WORCESTER
ZIP	01655-0002
OFFICIAL VA NAME	LAKE AVENUE VA CLINIC
INACTIVE FACILITY FLAG	INACTIVE
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 1 PARENT FACILITY PARENT OF ASSOCIATION: VA CNTRL WSTRN MASSCHUSETS HCS
BILLING FACILITY NAME	WORCESTER 2 VA CLINIC
EFFECTIVE DATE/TIME	2016-10-15 00:00:00 STATUS: INACTIVE NPI: 1407399298
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	EASTERN
COUNTRY	USA
STATION NUMBER	631QB