Healthcare Provider Details

I. General information

NPI: 1174739429
Provider Name (Legal Business Name): PREPARATORY REHABILITATION FOR INDIVIDUAL DEVELOPMENT & EMPLOYMENT, IN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 MAPLE ST
TAUNTON MA
02780-3012
US

IV. Provider business mailing address

3 MAPLE ST
TAUNTON MA
02780-3012
US

V. Phone/Fax

Practice location:
  • Phone: 508-823-7134
  • Fax: 508-824-5699
Mailing address:
  • Phone: 508-823-7134
  • Fax: 508-824-5699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: MISS SARAH S CAMPBELL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 508-823-7134