Provider Demographics
NPI:1467591172
Name:SOUTH NORFOLK COUNTY ASSOCIATION FOR RETARDED CITIZENS, INC
Entity Type:Organization
Organization Name:SOUTH NORFOLK COUNTY ASSOCIATION FOR RETARDED CITIZENS, INC
Other - Org Name:SENIOR CONNECTIONS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:ABEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:781-762-4001
Mailing Address - Street 1:789 CLAPBOARDTREE ST
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-1717
Mailing Address - Country:US
Mailing Address - Phone:781-762-4001
Mailing Address - Fax:781-461-5950
Practice Address - Street 1:2070 CENTRE ST
Practice Address - Street 2:
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-3328
Practice Address - Country:US
Practice Address - Phone:617-469-1986
Practice Address - Fax:617-469-0571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
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
MA1948598Medicaid