Provider Demographics
NPI:1770866089
Name:EASTERN MIDDLESEX ALCOHOLISM SERVICES, INC
Entity Type:Organization
Organization Name:EASTERN MIDDLESEX ALCOHOLISM SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LADC-1
Authorized Official - Phone:781-321-2600
Mailing Address - Street 1:12 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-3883
Mailing Address - Country:US
Mailing Address - Phone:781-321-2600
Mailing Address - Fax:781-321-2600
Practice Address - Street 1:12 CEDAR ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-3883
Practice Address - Country:US
Practice Address - Phone:781-321-2600
Practice Address - Fax:781-321-2600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0225324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility