Healthcare Provider Details

I. General information

NPI: 1962548024
Provider Name (Legal Business Name): MEETING STREET MASSACHUSETTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 POSA PLACE
DARTMOUTH MA
02747-2511
US

IV. Provider business mailing address

1 POSA PLACE
DARTMOUTH MA
02747-2511
US

V. Phone/Fax

Practice location:
  • Phone: 508-996-3391
  • Fax: 508-996-3397
Mailing address:
  • Phone: 508-996-3391
  • Fax: 508-996-3397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH JANE ISHERWOOD
Title or Position: DIRECTOR OF OUTPATIENT REHAB
Credential:
Phone: 401-533-9250