Provider Demographics
NPI:1942814264
Name:NORTHEAST FAMILY SERVICES
Entity Type:Organization
Organization Name:NORTHEAST FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:IN HOME THERAPIST CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:FRANCELYS
Authorized Official - Middle Name:
Authorized Official - Last Name:DESARDEN FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:787-341-0989
Mailing Address - Street 1:280 MERRIMACK ST STE 312
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1779
Mailing Address - Country:US
Mailing Address - Phone:774-206-1125
Mailing Address - Fax:774-628-9657
Practice Address - Street 1:299 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3646
Practice Address - Country:US
Practice Address - Phone:774-320-0361
Practice Address - Fax:774-628-9657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty