Provider Demographics
NPI:1760191357
Name:AMERICARE BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:AMERICARE BEHAVIORAL HEALTH, LLC
Other - Org Name:AMERICARE BEHAVIORAL HEALTH AFC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:KIIO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:978-770-5743
Mailing Address - Street 1:599 CANAL ST FL 6E
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840-1244
Mailing Address - Country:US
Mailing Address - Phone:978-770-5743
Mailing Address - Fax:888-900-1292
Practice Address - Street 1:599 CANAL ST FL 6E
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1244
Practice Address - Country:US
Practice Address - Phone:978-770-5743
Practice Address - Fax:888-900-1292
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICARE BEHAVIORAL HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-22
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253J00000XAgenciesFoster Care AgencyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110186992Medicaid