Organization
DEPARTMENT OF PUBLIC HEALTH - EARLY INTERVENTION PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL WEISBERG (CHIEF FINANCIAL OFFICER)
(617) 624-5260
Entity
Organization
Contact information
Practice address
250 WASHINGTON ST, 2ND FLOOR, BOSTON, MA 02108-4603
(617) 624-5260
Mailing address
250 WASHINGTON ST, 2ND FLOOR, BOSTON, MA 02108-4603
(617) 624-5260
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1803468
—
MA
Enumeration date
04/06/2007
Last updated
10/23/2007
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