Organization
AGESPAN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOAN HATEM-ROY LICSW (EXECUTIVE DIRECTOR)
(978) 683-7747
Entity
Organization
Contact information
Practice address
280 MERRIMACK ST, SUITE 400, LAWRENCE, MA 01843
(978) 683-7747
(978) 687-1067
Mailing address
280 MERRIMACK ST, SUITE 400, LAWRENCE, MA 01843-1779
(978) 683-7747
(978) 687-1067
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0603864
WAIVER
MA
Enumeration date
03/07/2007
Last updated
04/25/2022
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