Healthcare Provider Details

I. General information

NPI: 1881722437
Provider Name (Legal Business Name): CRITERION CHILD ENRICHMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 12/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 FORTUNE BLVD
MILFORD MA
01757-1723
US

IV. Provider business mailing address

345 FORTUNE BLVD
MILFORD MA
01757-1723
US

V. Phone/Fax

Practice location:
  • Phone: 508-473-3422
  • Fax:
Mailing address:
  • Phone: 508-473-3422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: ROBERT F LITTLETON JR.
Title or Position: PRESIDENT
Credential:
Phone: 508-478-2631