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General NPI Number Information
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NPI Number | 1164562062
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Entity Type | Organization
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Legal Business Name | SOUTH SHORE ARC, INC
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 574 MAIN ST
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City | SOUTH WEYMOUTH
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State | MA
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Zip | 02190-1818
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Country | US
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Telephone | 781-331-2533
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Fax |
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Provider Business Mailing Address
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Address Line | 371 RIVER ST
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City | NORTH WEYMOUTH
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State | MA
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Zip | 02191-2200
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Country | US
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Telephone | 781-335-3023
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. DARLY COOK
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Credential |
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Telephone | 781-335-3025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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