Provider Demographics
NPI:1134278351
Name:SOUTH EASTERN REGIONAL EDUCATION SERVICE CENTER
Entity Type:Organization
Organization Name:SOUTH EASTERN REGIONAL EDUCATION SERVICE CENTER
Other - Org Name:SERESC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:G
Authorized Official - Last Name:PARADIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:603-206-6800
Mailing Address - Street 1:29 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6835
Mailing Address - Country:US
Mailing Address - Phone:603-206-6800
Mailing Address - Fax:
Practice Address - Street 1:29 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6835
Practice Address - Country:US
Practice Address - Phone:603-206-6800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty