Provider Demographics
NPI:1710452339
Name:AHAVA TREATMENT AND WELLNESS CENTER
Entity Type:Organization
Organization Name:AHAVA TREATMENT AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:HITCHMOTH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, ARNP, CNS, BC
Authorized Official - Phone:978-809-8203
Mailing Address - Street 1:5 WALLACE ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-6425
Mailing Address - Country:US
Mailing Address - Phone:978-809-8203
Mailing Address - Fax:
Practice Address - Street 1:5 WALLACE ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-6425
Practice Address - Country:US
Practice Address - Phone:978-809-8203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health