Provider Demographics
NPI:1134366487
Name:NORTHERN EDUCATIONAL SERVICES, INC,
Entity type:Organization
Organization Name:NORTHERN EDUCATIONAL SERVICES, INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-733-2238
Mailing Address - Street 1:736 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01109-4110
Mailing Address - Country:US
Mailing Address - Phone:413-787-2101
Mailing Address - Fax:413-737-4324
Practice Address - Street 1:736 STATE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109-4110
Practice Address - Country:US
Practice Address - Phone:413-787-2101
Practice Address - Fax:413-737-4324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0604251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1307401Medicaid
MA1508077942OtherMASSACHUSETTS BEHAVIORAL HEALTH PARTNERSHIP