Provider Demographics
NPI:1609998251
Name:CEREBRAL PALSY COUNCIL OF GREATER NB, INC
Entity Type:Organization
Organization Name:CEREBRAL PALSY COUNCIL OF GREATER NB, INC
Other - Org Name:SCHWARTZ CENTER EARLY INTERVENTION
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF CLIENT BILLING
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:ISHERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-533-9250
Mailing Address - Street 1:ONE POSA PLACE
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-2511
Mailing Address - Country:US
Mailing Address - Phone:508-996-3391
Mailing Address - Fax:508-996-3397
Practice Address - Street 1:ONE POSA PLACE
Practice Address - Street 2:
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-2511
Practice Address - Country:US
Practice Address - Phone:508-996-3391
Practice Address - Fax:508-996-3397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1803026Medicaid
MA601047OtherHARVARD PILGRIM HC
MA7509064OtherUNITED HEALTH CARE
MAEI0011OtherBLUE CROSS BLUE SHIELD
MA000000024885OtherBOSTON MEDICAL CENTER
MA0006553OtherNEIGHBORHOOD HEALTH PLAN
MA805001OtherTUFTS HEALTH PLAN