Provider Demographics
NPI:1104027499
Name:VALLEYHEAD, INC.
Entity Type:Organization
Organization Name:VALLEYHEAD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:413-637-3635
Mailing Address - Street 1:79 RESERVOIR ROAD
Mailing Address - Street 2:
Mailing Address - City:LENOX
Mailing Address - State:MA
Mailing Address - Zip Code:01240
Mailing Address - Country:US
Mailing Address - Phone:413-637-3635
Mailing Address - Fax:413-637-2912
Practice Address - Street 1:79 RESERVOIR RD
Practice Address - Street 2:
Practice Address - City:LENOX
Practice Address - State:MA
Practice Address - Zip Code:01240-2008
Practice Address - Country:US
Practice Address - Phone:413-637-3635
Practice Address - Fax:413-637-2912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1475451322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children