Healthcare Provider Details

I. General information

NPI: 1699363432
Provider Name (Legal Business Name): FRENCH RIVER EDUCATION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2021
Last Update Date: 01/07/2021
Certification Date: 01/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

672 MAIN ST
NORTH OXFORD MA
01537-1304
US

IV. Provider business mailing address

PO BOX 476
NORTH OXFORD MA
01537-0476
US

V. Phone/Fax

Practice location:
  • Phone: 508-987-0219
  • Fax:
Mailing address:
  • Phone: 508-987-0219
  • Fax: 508-987-1396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. RICCI W HALL JR.
Title or Position: DIRECTOR
Credential:
Phone: 508-987-0219