Provider Demographics
NPI:1780811257
Name:NEW ENGLAND VILLAGE INC
Entity type:Organization
Organization Name:NEW ENGLAND VILLAGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-293-5461
Mailing Address - Street 1:664 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-3607
Mailing Address - Country:US
Mailing Address - Phone:781-293-5461
Mailing Address - Fax:781-294-8385
Practice Address - Street 1:664 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-3607
Practice Address - Country:US
Practice Address - Phone:781-293-5461
Practice Address - Fax:781-294-8385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA110028180B251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110028180BOtherMASS HEALTH PROVIDER NUMBER