Healthcare Provider Details

I. General information

NPI: 1720061609
Provider Name (Legal Business Name): CHILDRENS AID & FAMILY SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 03/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 ERDMAN WAY
LEOMINSTER MA
01453-1819
US

IV. Provider business mailing address

110 ERDMAN WAY
LEOMINSTER MA
01453-1819
US

V. Phone/Fax

Practice location:
  • Phone: 978-534-5218
  • Fax: 978-534-5309
Mailing address:
  • Phone: 978-534-5218
  • Fax: 978-534-5309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CHERYL TRANT
Title or Position: VICE PRESIDENT
Credential:
Phone: 978-534-5218