Provider Demographics
NPI:1629389010
Name:MASS. DEPARTMENT OF DEVELOPMENTAL SERVICES
Entity Type:Organization
Organization Name:MASS. DEPARTMENT OF DEVELOPMENTAL SERVICES
Other - Org Name:DDS ASSISTIVE TECHNOLOGY UNIT
Other - Org Type:Other Name
Authorized Official - Title/Position:COMMISSIONER, MASS, DEPARTMENT OF D
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-624-7723
Mailing Address - Street 1:500 HARRISON AVENUE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2439
Mailing Address - Country:US
Mailing Address - Phone:617-624-7723
Mailing Address - Fax:617-624-7577
Practice Address - Street 1:450 MAPLE STREET
Practice Address - Street 2:KELLEY ASSISTIVE TECHNOLOGY CENTER, HOGAN REGIONAL CENT
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-4009
Practice Address - Country:US
Practice Address - Phone:978-774-5000
Practice Address - Fax:978-739-0417
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMM. OF MASS, DEPARTMENT OF DEVELOPMENTAL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorGroup - Multi-Specialty
No225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology PractitionerGroup - Multi-Specialty
No225CA2500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology SupplierGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235500000XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty