Provider Demographics
NPI:1720061609
Name:CHILDRENS AID & FAMILY SERVICE, INC.
Entity Type:Organization
Organization Name:CHILDRENS AID & FAMILY SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:TRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-534-5218
Mailing Address - Street 1:110 ERDMAN WAY
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-1819
Mailing Address - Country:US
Mailing Address - Phone:978-534-5218
Mailing Address - Fax:978-534-5309
Practice Address - Street 1:110 ERDMAN WAY
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-1819
Practice Address - Country:US
Practice Address - Phone:978-534-5218
Practice Address - Fax:978-534-5309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM14482OtherBCBS
MAM14482OtherBCBS