Provider Demographics
NPI:1578177598
Name:AFTERMATH ADDICTION TREATMENT LLC
Entity Type:Organization
Organization Name:AFTERMATH ADDICTION TREATMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:GANEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-435-9783
Mailing Address - Street 1:607 NORTH AVE STE 11E
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-1322
Mailing Address - Country:US
Mailing Address - Phone:781-587-3635
Mailing Address - Fax:781-587-3636
Practice Address - Street 1:607 NORTH AVE STE 11E
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-1322
Practice Address - Country:US
Practice Address - Phone:781-587-3635
Practice Address - Fax:781-587-3636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty