Organization
SB TRANSITIONAL SUB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PATRICIA RODENBERG-ROBERTS (VP & SR. ASST GENERAL COUNSEL)
(952) 836-2234
Entity
Organization
Contact information
Practice address
1115 W CHESTNUT ST, BROCKTON, MA 02301-7501
(508) 521-2200
Mailing address
1115 W CHESTNUT ST, BROCKTON, MA 02301-7501
(508) 521-2200
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
02/16/2021
Last updated
11/27/2023
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