Organization
COMMONWEALTH OF MASSACHUSETS
Active
Parent organization
COMMONWEALTH OF MASSACHUSETS
Other names
Wrentham Developmental Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMONWEALTH OF MASSACHUSETS
Authorized official
DYLAN LATTIMORE (DEPUTY COMMISSIONER FOR ADMINISTRAT)
(857) 408-0675
Entity
Organization
Contact information
Practice address
131 EMERALD STREET, WRENTHAM, MA 02093
(508) 384-3114
(508) 384-1619
Mailing address
40 BROAD STREET, 4TH FLOOR, BOSTON, MA 02109
(617) 727-5608
(617) 624-7577
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
EXEMPT
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0916315
—
MA
05
—
110000087F
—
MA
Enumeration date
03/12/2007
Last updated
03/19/2026
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