Provider Demographics
NPI:1003327453
Name:STETSON SCHOOL INC., AN AFFILIATE OF SEVEN HILLS FOUNDATION
Entity Type:Organization
Organization Name:STETSON SCHOOL INC., AN AFFILIATE OF SEVEN HILLS FOUNDATION
Other - Org Name:STETSON SCHOOL INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MARKETING AND REFERRALS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:STAITI
Authorized Official - Suffix:
Authorized Official - Credentials:BA, BS
Authorized Official - Phone:978-355-4541
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:MA
Mailing Address - Zip Code:01005-0309
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:455 SOUTH ST
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:MA
Practice Address - Zip Code:01005-8909
Practice Address - Country:US
Practice Address - Phone:978-355-4541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9028371322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3083083Medicaid