Provider Demographics
NPI:1770864126
Name:JOHN ASHFORD LINK HOUSE INC
Entity type:Organization
Organization Name:JOHN ASHFORD LINK HOUSE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OUTPATIENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:IANDOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-462-0787
Mailing Address - Street 1:110 HAVERHILL RD STE 206
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-2157
Mailing Address - Country:US
Mailing Address - Phone:978-462-0787
Mailing Address - Fax:
Practice Address - Street 1:110 HAVERHILL RD STE 206
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-2157
Practice Address - Country:US
Practice Address - Phone:978-462-0787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-30
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM1300X, 261QM0850X, 261QM0855X
MA0223324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA25371OtherDPH