Healthcare Provider Details

I. General information

NPI: 1548463953
Provider Name (Legal Business Name): STANLEY STREET TREATMENT AND RESOURSES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 05/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

386 STANLEY ST
FALL RIVER MA
02720-6009
US

IV. Provider business mailing address

386 STANLEY ST
FALL RIVER MA
02720-6009
US

V. Phone/Fax

Practice location:
  • Phone: 508-324-3557
  • Fax: 508-673-3182
Mailing address:
  • Phone: 508-324-3557
  • Fax: 508-673-3182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. NANCY PAULL
Title or Position: CEO
Credential:
Phone: 508-324-3555