Provider Demographics
NPI:1003433210
Name:ATENTIV LLC
Entity Type:Organization
Organization Name:ATENTIV LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-954-0494
Mailing Address - Street 1:100 CUMMINGS CTR STE 451C
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6132
Mailing Address - Country:US
Mailing Address - Phone:508-954-0494
Mailing Address - Fax:
Practice Address - Street 1:100 CUMMINGS CTR STE 451C
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6132
Practice Address - Country:US
Practice Address - Phone:508-954-0494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-03
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health