Organization
PENIKESE ISLAND SCHOOL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MANDI KOSAKOWSKI (ADMINISTRATOR/THIRD PARTY BILLING)
(603) 353-9102
Entity
Organization
Contact information
Practice address
565 WOODS HOLE RD, WOODS HOLE, MA 02543-1041
(508) 548-7276
(508) 457-9580
Mailing address
PO BOX 161, WOODS HOLE, MA 02543-0161
(508) 548-7276
(508) 457-9580
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
0203
MA
Other
Enumeration date
09/10/2014
Last updated
09/10/2014
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