Provider Demographics
NPI:1346374832
Name:THE KOLBURNE SCHOOL, INC.
Entity Type:Organization
Organization Name:THE KOLBURNE SCHOOL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANE
Authorized Official - Middle Name:K
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:413-229-8787
Mailing Address - Street 1:343 NEW MARLBORO SOUTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NEW MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01230-2035
Mailing Address - Country:US
Mailing Address - Phone:413-229-8787
Mailing Address - Fax:413-229-4165
Practice Address - Street 1:343 NEW MARLBORO SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:NEW MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01230-2035
Practice Address - Country:US
Practice Address - Phone:413-229-8787
Practice Address - Fax:413-229-4165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5589A322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIKS03956OtherDCYF PROVIDER NUMBER