Provider Demographics
NPI:1619009784
Name:THE GUIDANCE CENTER, INC.
Entity Type:Organization
Organization Name:THE GUIDANCE CENTER, INC.
Other - Org Name:CAMBRIDGE-SOMERVILLE EARLY INTERVENTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AYERS
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:617-354-2275
Mailing Address - Street 1:5 SACRAMENTO ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1812
Mailing Address - Country:US
Mailing Address - Phone:617-354-2275
Mailing Address - Fax:617-547-4356
Practice Address - Street 1:61 MEDFORD ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-3429
Practice Address - Country:US
Practice Address - Phone:617-629-3919
Practice Address - Fax:617-629-4644
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE GUIDANCE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA721991OtherTUFTS
MA614913OtherHPHC
MAEI0016OtherBCBS
MA1800396Medicaid
MA6785839OtherCIGNA