Organization
CRYSTAL SPRINGS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN LOVENBURY (CHIEF EXECUTIVE OFFICER)
(774) 855-3176
Entity
Organization
Contact information
Practice address
38 NARROWS ROAD, ASSONET, MA 02702-0372
(508) 644-3101
(508) 644-2008
Mailing address
38 NARROWS ROAD, P.O. BOX 372, ASSONET, MA 02702-0372
(508) 644-3101
(508) 644-2008
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035224700
—
WA
05
—
1312014
—
MA
05
—
1318071
—
MA
Enumeration date
03/22/2007
Last updated
01/08/2018
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