Healthcare Provider Details

I. General information

NPI: 1508131483
Provider Name (Legal Business Name): NASHOBA LEARNING GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2012
Last Update Date: 03/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 OAK PARK DR
BEDFORD MA
01730-1414
US

IV. Provider business mailing address

10 OAK PARK DR
BEDFORD MA
01730-1414
US

V. Phone/Fax

Practice location:
  • Phone: 781-275-2500
  • Fax: 781-275-2510
Mailing address:
  • Phone: 781-275-2500
  • Fax: 781-275-2510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. MAUREEN REILLY VIBERT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 781-275-2500