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Health and Education Services

Organization Active NPI Mental Illness Intermediate Care Facility · Haverhill, MA

NPI 1366612905 · NPPES record last updated Mar 11, 2008

Key facts

NPI
1366612905
Entity type
Organization (NPI type 2)
Primary specialty
Mental Illness Intermediate Care Facility 310500000X
License
113175 (MA)
Legal business name
HEALTH AND EDUCATION SERVICES
Practice address
60 Merrimack St
Haverhill, MA 01830-6207
Phone
(978) 373-1126
Fax
(978) 373-6363
NPI assigned
Mar 11, 2008
Organization subpart
No

Authorized official

Name
Ms. Gwen E Owen, LICSW
Title
Geriatric Clinician
Phone
(978) 373-1126

Corporate family (same tax ID) 17

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

National Provider Directory

Tax ID family
Northeast Behavioral Health (18 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Intermediate Care Facility 310500000X 113175 MA Yes

Addresses

Primary practice location

60 Merrimack St
Haverhill, MA 01830-6207

Mailing address

60 Merrimack St
Haverhill, MA 01830-6207
Phone (978) 373-1126

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 11, 2008.

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1366612905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MERRIMACK ST",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306207",
            "telephone_number": "978-373-1126",
            "fax_number": "978-373-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MERRIMACK ST",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306207",
            "telephone_number": "978-373-1126",
            "fax_number": "978-373-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH AND EDUCATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "GWEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "GERIATRIC CLINICIAN",
        "authorized_official_telephone_number": "978-373-1126",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "MA",
            "license": "113175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverhill, MA

All providers in Haverhill, MA · Mental Illness Intermediate Care Facility in Massachusetts

Sources for this page

Verify at the official NPI Registry.