Healthcare Provider Details
I. General information
NPI: 1790795052
Provider Name (Legal Business Name): CUTCHINS PROGRAMS FOR CHILDREN AND FAMILIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
78 POMEROY TER
NORTHAMPTON MA
01060-3378
US
IV. Provider business mailing address
78 POMEROY TER
NORTHAMPTON MA
01060-3378
US
V. Phone/Fax
- Phone: 413-584-1310
- Fax: 413-586-1490
- Phone: 413-584-1310
- Fax: 413-586-1490
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | 4159 |
| License Number State | MA |
VIII. Authorized Official
Name: MR.
ANDREW
POLLOCK
Title or Position: EXECUTIVE DIRECTOR
Credential: MED
Phone: 413-584-1310