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Organization

DOUGLAS A. THOM CLINIC, INC.

Active
Other names
Thom Child & Family Services
Organization subpart
No

Provider details

NPI number
Authorized official
GRETCHEN ROWE OWENS (EXECUTIVE DIRECTOR)
(508) 655-5222
Entity
Organization

Contact information

Practice address
126 PHOENIX AVE, BUILDING #2, LOWELL, MA 01852-4931
(978) 453-8331
(978) 453-9254
Mailing address
251 W CENTRAL ST, SUITE 22, NATICK, MA 01760-3758
(508) 655-5222
(508) 655-9737

Taxonomy

Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
008838
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1800353
MA
05
1800574
MA
05
1802097
MA
05
1802976
MA
05
1803131
MA
05
1803301
MA
05
1887271
MA
05
1887289
MA
Enumeration date
06/25/2006
Last updated
05/01/2017
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