Provider Demographics
NPI:1033288907
Name:CUTCHINS PROGRAMS
Entity Type:Organization
Organization Name:CUTCHINS PROGRAMS
Other - Org Name:THREE RIVERS PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:CHABOT
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:413-733-4032
Mailing Address - Street 1:31 COUNTRY WAY
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-1025
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26 RIDGEWOOD TER
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01105-1315
Practice Address - Country:US
Practice Address - Phone:413-733-4032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1026673322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1026673OtherLICSW (PROF. LICENSE)