Organization
GREAT BAY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA ANN LOWY (EXECUTIVE DIRECTOR)
(617) 435-4365
Entity
Organization
Contact information
Practice address
23 CATARACT AVE # 1, DOVER, NH 03820-3908
(603) 842-5344
(603) 343-4465
Mailing address
23 CATARACT AVE # 1, DOVER, NH 03820-3908
(603) 842-5344
(603) 343-4465
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245626316
—
NH
05
—
1780827881
—
NH
05
—
1952796864
—
ME
Enumeration date
02/23/2016
Last updated
10/06/2022
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