Provider Demographics
NPI:1609176635
Name:THE ARC OF THE SOUTH SHORE, INC
Entity Type:Organization
Organization Name:THE ARC OF THE SOUTH SHORE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BEJAMIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCHNELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-335-3023
Mailing Address - Street 1:THE ARC OF THE SOUTH SHORE, INC
Mailing Address - Street 2:20 POND PARK RD
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043
Mailing Address - Country:US
Mailing Address - Phone:781-335-3023
Mailing Address - Fax:781-335-3682
Practice Address - Street 1:THE ARC OF THE SOUTH SHORE, INC
Practice Address - Street 2:20 POND PARK RD
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043
Practice Address - Country:US
Practice Address - Phone:781-335-3023
Practice Address - Fax:781-335-3682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110027983EMedicaid