Organization
LATHAM CENTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE MIMMO (NURSE MANAGER)
(508) 896-5776
Entity
Organization
Contact information
Practice address
1646 MAIN ST, BREWSTER, MA 02631-1716
(508) 896-5776
(508) 896-6782
Mailing address
1646 MAIN ST, BREWSTER, MA 02631-1716
(508) 896-5776
(508) 896-6782
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
1476466
MA
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
1476467
MA
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
1476468
MA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
9012334
MA
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
9012336
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LA 94288
—
RI
Enumeration date
08/24/2010
Last updated
08/08/2024
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