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General NPI Number Information
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NPI Number | 1215296603
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Entity Type | Organization
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Legal Business Name | THE RECREATIONAL EDUCATION CENTER, LLC
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Dates
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Enumeration Date | 05/07/2012
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Last Update Date | 05/07/2012
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Provider Practice Location Address
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Address Line | 83 PINE ST 102
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City | PEABODY
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State | MA
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Zip | 01960-3646
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Country | US
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Telephone | 978-717-5062
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Fax |
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Provider Business Mailing Address
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Address Line | 83 PINE ST 102
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City | PEABODY
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State | MA
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Zip | 01960-3646
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Country | US
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Telephone |
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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 | TRICIA WOOLARD
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Credential |
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Telephone | 978-717-5062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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