Provider Demographics
NPI:1073739702
Name:BAY COVE HUMAN SERVICES INC.
Entity Type:Organization
Organization Name:BAY COVE HUMAN SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNORS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-371-3000
Mailing Address - Street 1:7 COLTIN DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-4505
Mailing Address - Country:US
Mailing Address - Phone:978-255-2978
Mailing Address - Fax:
Practice Address - Street 1:100 EVERETT AVE STE 4
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2374
Practice Address - Country:US
Practice Address - Phone:978-255-2978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1965251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1965OtherLICENSED SUBSTANCE ABUSE