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General NPI Number Information
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NPI Number | 1619009784
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Entity Type | Organization
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Legal Business Name | THE GUIDANCE CENTER, INC.
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 11/12/2007
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Provider Practice Location Address
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Address Line | 61 MEDFORD ST
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City | SOMERVILLE
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State | MA
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Zip | 02143-3429
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Country | US
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Telephone | 617-629-3919
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Fax | 617-629-4644
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Provider Business Mailing Address
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Address Line | 5 SACRAMENTO ST
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City | CAMBRIDGE
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State | MA
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Zip | 02138-1812
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Country | US
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Telephone | 617-354-2275
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Fax | 617-547-4356
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SUSAN AYERS
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Credential | LICSW
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Telephone | 617-354-2275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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