Provider Demographics
NPI:1164559803
Name:TOWARD INDEPENDENT LIVING & LEARNING, INC.
Entity Type:Organization
Organization Name:TOWARD INDEPENDENT LIVING & LEARNING, INC.
Other - Org Name:TILL, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT - OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:STOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:781-302-4604
Mailing Address - Street 1:20 EASTBROOK RD
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-2075
Mailing Address - Country:US
Mailing Address - Phone:781-302-4604
Mailing Address - Fax:781-234-1104
Practice Address - Street 1:577 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:MA
Practice Address - Zip Code:01749
Practice Address - Country:US
Practice Address - Phone:781-302-4604
Practice Address - Fax:781-234-1104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1305107Medicaid