Organization
TEAM COORDINATING AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN GRADY (AMBULATORY SERVICES DIVISION DIRECT)
(978) 373-1181
Entity
Organization
Contact information
Practice address
76 WINTER ST, HAVERHILL, MA 01830-5760
(978) 374-7605
Mailing address
76 WINTER ST, HAVERHILL, MA 01830-5760
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
111893
MA
Other
Enumeration date
06/27/2008
Last updated
06/27/2008
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