Provider Demographics
NPI:1669511168
Name:COOPERATIVE PRODUCTION, INC.
Entity Type:Organization
Organization Name:COOPERATIVE PRODUCTION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-824-1717
Mailing Address - Street 1:PO BOX 506
Mailing Address - Street 2:455 SOMERSET AVE.
Mailing Address - City:NORTH DIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02764-0506
Mailing Address - Country:US
Mailing Address - Phone:508-824-1717
Mailing Address - Fax:508-822-0919
Practice Address - Street 1:455 SOMERSET AVE
Practice Address - Street 2:
Practice Address - City:NORTH DIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02764-1811
Practice Address - Country:US
Practice Address - Phone:508-824-1717
Practice Address - Fax:508-822-0919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1306898251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1306898Medicaid