Healthcare Provider Details
I. General information
NPI: 1649347691
Provider Name (Legal Business Name): SERVICENET INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/28/2006
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
131 KING ST
NORTHAMPTON MA
01060-3234
US
IV. Provider business mailing address
129 KING ST
NORTHAMPTON MA
01060-3258
US
V. Phone/Fax
- Phone: 413-566-5871
- Fax:
- Phone: 413-585-1400
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 252Y00000X |
| Taxonomy | Early Intervention Provider Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
SACCENTO
Title or Position: CEFO
Credential:
Phone: 413-585-1300