National Provider Identifier Database

DEPARTMENT OF DEVELOPMENTAL SERVICES
Intermediate Care Facility, Mentally Retarded

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.


Contact Information

DEPARTMENT OF DEVELOPMENTAL SERVICES
GLAVIN REGIONAL CNTR
214 LAKE ST
SHREWSBURY, MA01545
Phone: 508-792-7452
Fax:
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for DEPARTMENT OF DEVELOPMENTAL SERVICES

NPI Number 1659594976
Legal business name
LBN
DEPARTMENT OF DEVELOPMENTAL SERVICES
Authorized official JEANETTE MAILLET - (C F O)
Entity Organization
Organization subpart No
Enumeration date 04/11/2007
Last updated 09/29/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • MA Medicaid: 913804

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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