Provider Demographics
NPI:1679602676
Name:CENTRAL MIDDLESEX ASSOCIATION FOR RETARDED CITIZENS, INC.
Entity Type:Organization
Organization Name:CENTRAL MIDDLESEX ASSOCIATION FOR RETARDED CITIZENS, INC.
Other - Org Name:CMARC, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-935-7057
Mailing Address - Street 1:147 NEW BOSTON ST
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-6201
Mailing Address - Country:US
Mailing Address - Phone:781-935-7057
Mailing Address - Fax:781-935-4227
Practice Address - Street 1:147 NEW BOSTON ST
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-6201
Practice Address - Country:US
Practice Address - Phone:781-935-7057
Practice Address - Fax:781-935-4227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1311298Medicaid