Provider Demographics
NPI:1114107034
Name:SEVENHILLS CLINICAL ASSOCIATES
Entity Type:Organization
Organization Name:SEVENHILLS CLINICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. VP
Authorized Official - Prefix:MS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:VERONICA
Authorized Official - Last Name:CHASE
Authorized Official - Suffix:
Authorized Official - Credentials:MED CCC
Authorized Official - Phone:978-772-7170
Mailing Address - Street 1:22 GRANT RD
Mailing Address - Street 2:
Mailing Address - City:DEVENS
Mailing Address - State:MA
Mailing Address - Zip Code:01434-4468
Mailing Address - Country:US
Mailing Address - Phone:978-772-7170
Mailing Address - Fax:978-772-7188
Practice Address - Street 1:22 GRANT RD
Practice Address - Street 2:
Practice Address - City:DEVENS
Practice Address - State:MA
Practice Address - Zip Code:01434-4468
Practice Address - Country:US
Practice Address - Phone:978-772-7170
Practice Address - Fax:978-772-7188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA206970252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency