Healthcare Provider Details

I. General information

NPI: 1326114711
Provider Name (Legal Business Name): PARTNERS IN CHILD DEVELOPMENT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 OSGOOD ST
ANDOVER MA
01810-5411
US

IV. Provider business mailing address

32 OSGOOD ST
ANDOVER MA
01810-5411
US

V. Phone/Fax

Practice location:
  • Phone: 978-475-3806
  • Fax: 978-475-6288
Mailing address:
  • Phone: 978-475-3806
  • Fax: 978-475-6288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number017069
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIAN HUNT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 978-475-3806