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General NPI Number Information
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NPI Number | 1578128815
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Entity Type | Organization
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Legal Business Name | LATHAM CENTERS, INC.
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Dates
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Enumeration Date | 05/02/2019
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Last Update Date | 05/02/2019
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Provider Practice Location Address
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Address Line | 1646 MAIN ST
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City | BREWSTER
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State | MA
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Zip | 02631-1716
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Country | US
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Telephone | 774-353-9201
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Fax |
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Provider Business Mailing Address
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Address Line | 1646 MAIN ST
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City | BREWSTER
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State | MA
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Zip | 02631-1716
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Country | US
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Telephone | 774-353-9201
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Fax |
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Authorized Official
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Title or Position | CONTROLLER
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Name | MEREDITH MORGAN
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Credential |
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Telephone | 774-353-9201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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