Provider Demographics
NPI:1699077404
Name:CARDINAL CUSHING CENTERS, INC.
Entity type:Organization
Organization Name:CARDINAL CUSHING CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:SIGMUND
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:KOZARYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-829-1215
Mailing Address - Street 1:405 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-2343
Mailing Address - Country:US
Mailing Address - Phone:781-829-1215
Mailing Address - Fax:
Practice Address - Street 1:405 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-2343
Practice Address - Country:US
Practice Address - Phone:781-826-6371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health