Provider Demographics
NPI:1477605228
Name:ADDICTION TREATMENT CENTER OF NEW ENGLAND, INC.
Entity Type:Organization
Organization Name:ADDICTION TREATMENT CENTER OF NEW ENGLAND, INC.
Other - Org Name:ADDICTION TREATMENT CENTER OF NE
Other - Org Type:Other Name
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:O'DONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:617-254-1271
Mailing Address - Street 1:77WARREN STREET
Mailing Address - Street 2:BLDG.#5
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135
Mailing Address - Country:US
Mailing Address - Phone:617-254-1271
Mailing Address - Fax:617-782-7668
Practice Address - Street 1:77 WARREN ST
Practice Address - Street 2:BLDG.#5
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3601
Practice Address - Country:US
Practice Address - Phone:617-254-1271
Practice Address - Fax:617-782-7668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2023-03-27
Deactivation Date:2023-02-23
Deactivation Code:
Reactivation Date:2023-03-27
Provider Licenses
StateLicense IDTaxonomies
MA0617251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management