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NPI Code Detail

MEDICARE: FUTURES CLINIC, INC.

MEDICARE: FUTURES CLINIC, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1639435241
Entity Type Code : Organization
Provider Name (Legal Business Name) : FUTURES CLINIC, INC.
Provider Business Mailing Address
First Line : 55 TOZER RD
Second Line :
City : BEVERLY
State : MA
Zip : 01915-5515
Country : US
Telephone Number : 978-993-8096
Fax Number : 978-969-3021
Provider Business Practice Location Address
First Line : 55 TOZER RD
Second Line :
City : BEVERLY
State : MA
Zip : 01915-5515
Country : US
Telephone Number : 978-993-8096
Fax Number : 978-969-3021
Authorized Official
Title or Position : DIRECTOR
Name : JILL LARSEN
Credential : BCBA
Telephone Number : 978-993-8096
Provider Enumeration Date : 04/09/2012
Last Update Date : 04/09/2012

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Directions to “FUTURES CLINIC, INC. ” Practice Location

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