NPIMap

Organization Active NPI

Shore Educational Collaborative

  • Developmentally Disabled Services Day Training Agency
  • Wakefield, MA
National Provider Identifier
1730307505
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
SHORE EDUCATIONAL COLLABORATIVE
Practice address
4 Audubon Rd
Wakefield, MA 01880-1203
Phone
(781) 224-3466
NPI assigned
Apr 24, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Maryann Lucia
Title
Director of Finance
Phone
(617) 887-2930

Specialties & licenses 1

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

Addresses

Primary practice location

4 Audubon Rd
Wakefield, MA 01880-1203

Mailing address

4 Audubon Rd
Wakefield, MA 01880-1203
Phone (781) 224-3466

Other identifiers 1

IdentifierTypeStateIssuer
1308947MedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
Shore Educational Collaborative4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

4 Audubon Rd
Wakefield, MA 01880
Phone (781) 224-3466

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730307505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 AUDUBON RD",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018801203",
            "telephone_number": "781-224-3466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 AUDUBON RD",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018801203",
            "telephone_number": "781-224-3466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE EDUCATIONAL COLLABORATIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUCIA",
        "authorized_official_first_name": "MARYANN",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "617-887-2930",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1308947",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.