Provider Demographics
NPI:1275798076
Name:DEER OAKS NEW ENGLAND, LLC
Entity Type:Organization
Organization Name:DEER OAKS NEW ENGLAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BOSKIND
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:210-615-3472
Mailing Address - Street 1:7272 WURZBACH RD
Mailing Address - Street 2:SUITE 601
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-4801
Mailing Address - Country:US
Mailing Address - Phone:210-615-3472
Mailing Address - Fax:210-593-9863
Practice Address - Street 1:70 S WINOOSKI AVE
Practice Address - Street 2:SUITE 288
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-3898
Practice Address - Country:US
Practice Address - Phone:802-651-9700
Practice Address - Fax:210-593-9863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty