NPIMap

Organization Active NPI

Cardinal Cushing Centers, Inc.

Doing business as Life Opportunities Unlimited - South

  • Developmentally Disabled Services Day Training Agency
  • Hanover, MA
National Provider Identifier
1083092274
Registry record updated May 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
TN66483 Issued in MA
Legal business name
CARDINAL CUSHING CENTERS, INC.
Doing business as
Life Opportunities Unlimited - South
Practice address
291 Rockland St
Hanover, MA 02339-2385
Phone
(781) 829-1215
Fax
(781) 826-4421
NPI assigned
May 8, 2015
Last updated
May 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Sigmund Robert Kozaryn
Title
Vice President/Cfo
Phone
(781) 829-1215

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X TN66483 MA Primary

Addresses

Primary practice location

291 Rockland St
Hanover, MA 02339-2385

Mailing address

405 Washington St
Hanover, MA 02339-2343
Phone (781) 829-1215

Other identifiers 4

IdentifierTypeStateIssuer
1699077404MedicaidMA
1861765307MedicaidMA
1093839896MedicaidMA
1750583902MedicaidMA

Other names 1

  • Life Opportunities Unlimited - South Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cardinal Cushing Centers Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

291 Rockland St
Hanover, MA 02339
Phone (781) 829-1215

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431043200000",
    "number": "1083092274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 WASHINGTON ST",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023392343",
            "telephone_number": "781-829-1215",
            "fax_number": "781-826-4421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 ROCKLAND ST",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023392385",
            "telephone_number": "781-829-1215",
            "fax_number": "781-826-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDINAL CUSHING CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-08",
        "last_updated": "2015-05-08",
        "status": "A",
        "authorized_official_last_name": "KOZARYN",
        "authorized_official_first_name": "SIGMUND",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "VICE PRESIDENT/CFO",
        "authorized_official_telephone_number": "781-829-1215",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "MA",
            "license": "TN66483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699077404",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861765307",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093839896",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750583902",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Opportunities Unlimited - South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hanover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.