NPIMap

Organization Active NPI

Northeast Arc, Inc.

  • Developmental Disabilities Clinic/Center
  • Danvers, MA
National Provider Identifier
1548458243
Registry record updated Mar 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
NORTHEAST ARC, INC.
Practice address
64 Holten St
Danvers, MA 01923-1973
Phone
(978) 762-4878
Fax
(978) 777-6149
NPI assigned
Oct 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2015

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

Authorized official

Name
Mr. Gary Penniman
Title
Cfo
Phone
(978) 624-2445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

64 Holten St
Danvers, MA 01923-1973

Mailing address

64 Holten St
Danvers, MA 01923-1973
Phone (978) 762-4878

Other identifiers 1

IdentifierTypeStateIssuer
1802984MedicaidMA

Other names 1

  • North Shore Assoc For Retarded Citizens Inc Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Northeast Arc Inc17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426723200000",
    "number": "1548458243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 HOLTEN ST",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231973",
            "telephone_number": "978-762-4878",
            "fax_number": "978-777-6149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 HOLTEN ST",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231973",
            "telephone_number": "978-762-4878",
            "fax_number": "978-777-6149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ARC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2015-03-19",
        "status": "A",
        "authorized_official_last_name": "PENNIMAN",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "978-624-2445",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1802984",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Shore Assoc For Retarded Citizens Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Danvers, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; 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.