Organization
ANGEL CARE OT CENTER
Active
Organization
ANGEL CARE OT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN M LUSCOMB OTR (GENERAL PARTNER)
(978) 521-6150
Entity
Organization
Contact information
Practice address
70 MERRIMACK ST, HAVERHILL, MA 01830-6207
(978) 521-6150
(978) 521-2659
Mailing address
70 MERRIMACK ST, HAVERHILL, MA 01830-6207
(978) 521-6150
(978) 521-2659
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1763
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13Y005487MA01
ANTHEM BC
NH
01
—
EDS
MEDICAID
NH
01
—
OG0014
BCBS
MA
Enumeration date
12/28/2006
Last updated
08/22/2020
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