Provider Demographics
NPI:1932896792
Name:FRONT LINE SERVICES
Entity Type:Organization
Organization Name:FRONT LINE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:C
Authorized Official - Last Name:PAGE-SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:781-330-1366
Mailing Address - Street 1:486 CHESTNUT ST STE 2
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-3050
Mailing Address - Country:US
Mailing Address - Phone:781-330-1366
Mailing Address - Fax:
Practice Address - Street 1:486 CHESTNUT ST STE 2
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-3050
Practice Address - Country:US
Practice Address - Phone:781-330-1366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)