Healthcare Provider Details

I. General information

NPI: 1275367971
Provider Name (Legal Business Name): COMMUNITY TEAMWORK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2024
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 MERRIMACK ST
LOWELL MA
01852-1723
US

IV. Provider business mailing address

155 MERRIMACK ST
LOWELL MA
01852-1723
US

V. Phone/Fax

Practice location:
  • Phone: 978-459-0551
  • Fax: 978-454-6397
Mailing address:
  • Phone: 978-459-0551
  • Fax: 978-454-6397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: NANCY VAN ALST
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 978-459-0551