Provider Demographics
NPI:1982091898
Name:SECOND NATURE SOCIAL SKILLS
Entity Type:Organization
Organization Name:SECOND NATURE SOCIAL SKILLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SALVESEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-419-4393
Mailing Address - Street 1:15 MAIN STREET EXT STE 7
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-3383
Mailing Address - Country:US
Mailing Address - Phone:508-747-2663
Mailing Address - Fax:
Practice Address - Street 1:15 MAIN STREET EXT STE 7
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-3383
Practice Address - Country:US
Practice Address - Phone:508-747-2663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health