Organization
CAPEABILITIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY R THAYER (EXECUTIVE DIRECTOR)
(508) 778-5040
Entity
Organization
Contact information
Practice address
895 MARY DUNN RD, HYANNIS, MA 02601-2088
(508) 778-5040
(508) 778-9642
Mailing address
895 MARY DUNN RD, HYANNIS, MA 02601-2088
(508) 778-5040
(508) 778-9642
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
VC6000160849
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1319256
—
MA
05
—
1906496
—
MA
Enumeration date
01/18/2007
Last updated
08/22/2020
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