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General NPI Number Information
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NPI Number | 1881929503
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Entity Type | Organization
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Legal Business Name | NORTH COTTAGE PROGRAM, INC.
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Dates
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Enumeration Date | 10/14/2009
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Last Update Date | 10/14/2009
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Provider Practice Location Address
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Address Line | 69 E MAIN ST
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City | NORTON
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State | MA
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Zip | 02766-2307
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Country | US
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Telephone | 508-285-2701
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Fax | 508-285-2903
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Provider Business Mailing Address
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Address Line | 69 E MAIN ST
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City | NORTON
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State | MA
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Zip | 02766-2307
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Country | US
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Telephone | 508-285-2701
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Fax | 508-285-2903
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. LAURENCE E SCHNEIDER
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Credential |
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Telephone | 508-285-2701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 0240
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License Number State | MA
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