Provider Demographics
NPI:1164562062
Name:SOUTH SHORE ARC, INC
Entity Type:Organization
Organization Name:SOUTH SHORE ARC, INC
Other - Org Name:FIRST EARLY INTERVENTION
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DARLY
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-335-3025
Mailing Address - Street 1:371 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:NORTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02191-2200
Mailing Address - Country:US
Mailing Address - Phone:781-335-3023
Mailing Address - Fax:
Practice Address - Street 1:574 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1818
Practice Address - Country:US
Practice Address - Phone:781-331-2533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0182128OtherAETNA US HEALTHCARE
MA717088OtherTUFTS HEALTH PLAN
MA00000021024OtherBOSTON MEDICAL CENTER HEA
MA1801538Medicaid
MA410232OtherHEALTHCARE VALUE MANAGEME
MA2045129OtherCIGNA
MA7509020OtherUNITED HEALTHCARE
MA0008582OtherNEIGHBORHOOD HEALTH PLAN
MA34093OtherFALLON COMMUNITY HEALTH
MA603917OtherHARVARD PILGRIM HEALTH CA
MAEI0007OtherCLUE CROSS BLUE SHIELD