Provider Demographics
NPI:1609016385
Name:THE CHILDREN'S CHARTER INC.
Entity Type:Organization
Organization Name:THE CHILDREN'S CHARTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:STAHL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:781-894-4307
Mailing Address - Street 1:77 RUMFORD AVE
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-3872
Mailing Address - Country:US
Mailing Address - Phone:781-894-4307
Mailing Address - Fax:
Practice Address - Street 1:77 RUMFORD AVE
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-3872
Practice Address - Country:US
Practice Address - Phone:781-894-4307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA215544251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health