Organization
NORTHEAST BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE BALOGNA MA (INTERN)
(978) 373-1126
Entity
Organization
Contact information
Practice address
60 MERRIMACK ST, HAVERHILL, MA 01830-6207
(978) 373-1126
Mailing address
60 MERRIMACK ST, HAVERHILL, MA 01830-6207
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154302586
—
MA
Enumeration date
02/13/2012
Last updated
02/13/2012
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