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Organization

COMMONWEALTH OF MASSACHUSETTS

Active
Parent organization
COMMONWEALTH OF MASSACHUSETS
Other names
HOGAN REGIONAL CENTER
Organization subpart
Yes

Provider details

NPI number
Legal business name
COMMONWEALTH OF MASSACHUSETS
Authorized official
DYLAN LATTIMORE (DEPUTY COMMISSIONER OF ADMINSTRATIO)
(857) 408-0675
Entity
Organization

Contact information

Practice address
450 MAPLE ST, HATHORNE, MA 01937
(978) 774-5000
Mailing address
40 BROAD STREET, 4TH FLOOR, BOSTON, MA 02109
(617) 727-5608
(617) 624-7577

Taxonomy

Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0909505
MA
05
110000087A
MA
Enumeration date
08/15/2007
Last updated
03/19/2026
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