Provider Demographics
NPI:1790120830
Name:NEW ENGLAND BEHAVIORAL SERVICE, INC.
Entity Type:Organization
Organization Name:NEW ENGLAND BEHAVIORAL SERVICE, INC.
Other - Org Name:NEW ENGLAND BEHAVIORAL SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:508-838-0284
Mailing Address - Street 1:21 PARK ST.
Mailing Address - Street 2:SUITE 414
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703
Mailing Address - Country:US
Mailing Address - Phone:844-825-5222
Mailing Address - Fax:508-848-0101
Practice Address - Street 1:21 PARK ST.
Practice Address - Street 2:SUITE 414
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703
Practice Address - Country:US
Practice Address - Phone:844-825-5222
Practice Address - Fax:508-848-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-02
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty