Organization
ETS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA STORTI (PRESIDENT)
(978) 635-9144
Entity
Organization
Contact information
Practice address
201 GREAT RD, ACTON, MA 01720-5700
(978) 635-9144
Mailing address
201 GREAT RD, ACTON, MA 01720-5700
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110076510A
—
MA
Enumeration date
08/08/2013
Last updated
08/08/2013
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