Organization
COMMONWEALTH OF MASS - DDS
Active
Other names
FERNALD DEVELOPMENTAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
JEANETTE MAILLET (CHIEF FINANCIAL OFFICER)
(617) 727-5608
Entity
Organization
Contact information
Practice address
200 TRAPELO ROAD, BELMONT, MA 02452-6302
(781) 894-3600
Mailing address
500 HARRISON AVE, BOSTON, MA 02118-2439
(617) 727-5608
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0916307
—
MA
Enumeration date
03/08/2007
Last updated
10/01/2009
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