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General NPI Number Information
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NPI Number | 1659497253
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Entity Type | Organization
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Legal Business Name | THE HOME FOR LITTLE WANDERERS
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 02/26/2009
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Provider Practice Location Address
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Address Line | 780 AMERICAN LEGION HWY
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City | ROSLINDALE
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State | MA
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Zip | 02131-3908
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Country | US
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Telephone | 617-469-8692
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Fax |
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Provider Business Mailing Address
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Address Line | 6 GLORIA RD
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City | RANDOLPH
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State | MA
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Zip | 02368-4309
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Country | US
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Telephone | 781-963-3373
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MRS. KATRINA MICHELLE HUFF-LARMOND
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Credential | MSW
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Telephone | 617-469-8692
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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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