Provider Demographics
NPI:1801298898
Name:NORTHEAST ARC INC
Entity type:Organization
Organization Name:NORTHEAST ARC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:PENNIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-624-2445
Mailing Address - Street 1:6 SOUTHSIDE RD
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1409
Mailing Address - Country:US
Mailing Address - Phone:978-762-3635
Mailing Address - Fax:978-750-3639
Practice Address - Street 1:6 SOUTHSIDE RD
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1409
Practice Address - Country:US
Practice Address - Phone:978-624-2337
Practice Address - Fax:978-750-3639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-22
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health