Healthcare Provider Details

I. General information

NPI: 1770864126
Provider Name (Legal Business Name): JOHN ASHFORD LINK HOUSE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2011
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 HAVERHILL RD STE 206
AMESBURY MA
01913-2157
US

IV. Provider business mailing address

110 HAVERHILL RD STE 206
AMESBURY MA
01913-2157
US

V. Phone/Fax

Practice location:
  • Phone: 978-462-0787
  • Fax:
Mailing address:
  • Phone: 978-462-0787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number0223
License Number StateMA

VIII. Authorized Official

Name: DEANNA IANDOLO
Title or Position: DIRECTOR OF OUTPATIENT SERVICES
Credential:
Phone: 978-462-0787