Healthcare Provider Details

I. General information

NPI: 1346374832
Provider Name (Legal Business Name): THE KOLBURNE SCHOOL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 NEW MARLBORO SOUTHFIELD RD
NEW MARLBOROUGH MA
01230-2035
US

IV. Provider business mailing address

343 NEW MARLBORO SOUTHFIELD RD
NEW MARLBOROUGH MA
01230-2035
US

V. Phone/Fax

Practice location:
  • Phone: 413-229-8787
  • Fax: 413-229-4165
Mailing address:
  • Phone: 413-229-8787
  • Fax: 413-229-4165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number5589A
License Number StateMA

VIII. Authorized Official

Name: MRS. JEANE K. WEINSTEIN
Title or Position: EXECUTIVE DIRECTOR
Credential: MA
Phone: 413-229-8787