Healthcare Provider Details

I. General information

NPI: 1902933138
Provider Name (Legal Business Name): SOUTH SHORE EDUCATIONAL COLLABORATIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 POND PARK RD
HINGHAM MA
02043-4300
US

IV. Provider business mailing address

90 INDUSTRIAL PARK RD
HINGHAM MA
02043-4313
US

V. Phone/Fax

Practice location:
  • Phone: 781-749-5386
  • Fax: 781-740-4068
Mailing address:
  • Phone: 781-749-7518
  • Fax: 781-740-0784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAREN ERICKSON
Title or Position: BUSINESS MANAGER
Credential:
Phone: 781-749-7518