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General NPI Number Information
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NPI Number | 1689919516
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Entity Type | Organization
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Legal Business Name | CRITERION CHILD ENRICHMENT CRITERION-MIDDLESEX EARLY INTERVENTION
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Dates
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Enumeration Date | 12/04/2012
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Last Update Date | 12/04/2012
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Provider Practice Location Address
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Address Line | 651 FRANKLIN ST
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City | FRAMINGHAM
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State | MA
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Zip | 01702-2919
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Country | US
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Telephone | 508-620-1442
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Fax | 508-875-0806
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Provider Business Mailing Address
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Address Line | 651 FRANKLIN ST
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City | FRAMINGHAM
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State | MA
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Zip | 01702-2919
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Country | US
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Telephone | 508-620-1442
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Fax | 508-875-0806
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Authorized Official
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Title or Position | DEVELOPMENTAL SPECIALIST
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Name | MISS ERIN KATIE FINOCCHI
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Credential | MA
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Telephone | 508-620-1442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | S79448336
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License Number State | MA
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