Provider Demographics
NPI:1306183504
Name:PROJECT BEAM
Entity Type:Organization
Organization Name:PROJECT BEAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-528-7931
Mailing Address - Street 1:35 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-1827
Mailing Address - Country:US
Mailing Address - Phone:978-528-8596
Mailing Address - Fax:978-436-9418
Practice Address - Street 1:35 RIVER ST
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-1827
Practice Address - Country:US
Practice Address - Phone:978-528-8596
Practice Address - Fax:978-436-9418
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BILLERICA PUBLIC SCHOOLS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN201091252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency