Provider Demographics
NPI:1366041550
Name:MERRIMACK VALLEY ABA SERVICES INC
Entity Type:Organization
Organization Name:MERRIMACK VALLEY ABA SERVICES INC
Other - Org Name:MERRIMACK VALLEY ABA THERAPY SERVICES INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:ADDISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-208-9034
Mailing Address - Street 1:599 CANAL STREET
Mailing Address - Street 2:5TH FL EAST SUITE 15-16
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840
Mailing Address - Country:US
Mailing Address - Phone:978-983-0466
Mailing Address - Fax:978-983-0467
Practice Address - Street 1:599 CANAL STREET
Practice Address - Street 2:5TH FL EAST SUITE 15-16
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1245
Practice Address - Country:US
Practice Address - Phone:978-980-0466
Practice Address - Fax:978-983-0467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA001465731OtherBUSINESS CERTIFICATE IDENTIFICATION NUMBER
MA001465731OtherBUSINESS REGISTRATION CERTIFICATE NUMBER