Provider Demographics
NPI:1417181769
Name:SOUTHEASTERN MA EDUCATIONAL COLLABORATIVE
Entity Type:Organization
Organization Name:SOUTHEASTERN MA EDUCATIONAL COLLABORATIVE
Other - Org Name:SOUTHEASTERN MA EDUCATIONAL COLLABORATIVE ADULT DAY HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:508-998-5599
Mailing Address - Street 1:25 RUSSELLS MILLS ROAD
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02748
Mailing Address - Country:US
Mailing Address - Phone:508-858-5127
Mailing Address - Fax:508-858-5129
Practice Address - Street 1:25 RUSSELLS MILLS ROAD
Practice Address - Street 2:
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02748
Practice Address - Country:US
Practice Address - Phone:508-858-5127
Practice Address - Fax:508-858-5129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-14
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care