Provider Demographics
NPI:1689994188
Name:DARTMOUTH ELDERLY SERVICES/DARTMOUTH SOCIAL SERVICES
Entity Type:Organization
Organization Name:DARTMOUTH ELDERLY SERVICES/DARTMOUTH SOCIAL SERVICES
Other - Org Name:NEW ENGLAND DIAGNOSTIC AND LEARNING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:PAICOPOLOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-287-5413
Mailing Address - Street 1:14 SETH DAVIS WAY
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02748-1138
Mailing Address - Country:US
Mailing Address - Phone:508-287-5413
Mailing Address - Fax:
Practice Address - Street 1:14 SETH DAVIS WAY
Practice Address - Street 2:
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02748-1138
Practice Address - Country:US
Practice Address - Phone:508-287-5413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health