Bass River Day Activity Program, Inc

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

1319141 Issued in MA

Legal business name

BASS RIVER DAY ACTIVITY PROGRAM, INC

Doing business as

Bass River, Inc.

Practice address

12 Hanson St
Salem, MA 01970-1311

Phone

(978) 741-8740

Fax

(978) 741-2431

NPI assigned

Feb 27, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Edward A Potvin

Title

Executive Director

Phone

(978) 927-5326

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bass River, Inc. Doing business as

Tax ID family

Bass River Day Activity Program Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Bass River Day Activity Program, Inc.

  dba Bass River, Inc

  • Developmentally Disabled Services Day Training Agency
  • Beverly, MA
  • NPI 1629105382
  NPD tax ID

Locations

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487780805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 ESSEX ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151311",
            "telephone_number": "978-927-5326",
            "fax_number": "978-922-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 HANSON ST",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019701311",
            "telephone_number": "978-741-8740",
            "fax_number": "978-741-2431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASS RIVER DAY ACTIVITY PROGRAM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POTVIN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "978-927-5326",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "MA",
            "license": "1319141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1319141",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bass River, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Bartlett, NP
• Andrew J Barton, M.D.
• Yelena Katsman Baskin, PH.D.
• Samjhana Basnyat, M.D.
• Melissa Ruth Basque, M.ED.
• Jeff Charles Bauer, DMD
• Stephanie Baumann, LICSW
• Batuhan Bayram
• Christine Baze, LMFT
• Mark Michael Beal

• Developmentally Disabled Services Day Training Agency in Salem, MA
• Providers in Salem, MA by specialty
• Developmentally Disabled Services Day Training Agency in Massachusetts

• 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.