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General NPI Number Information
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NPI Number | 1649915612
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Entity Type | Organization
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Legal Business Name | ANCHOR BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 05/03/2022
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 1 COURTHOUSE LN STE 3
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City | CHELMSFORD
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State | MA
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Zip | 01824-1744
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Country | US
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Telephone | 774-420-8961
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Fax |
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Provider Business Mailing Address
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Address Line | 225 CEDAR HILL ST STE 200
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City | MARLBOROUGH
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State | MA
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Zip | 01752-5900
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Country | US
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Telephone | 774-420-8961
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | JACQUELYNNE KIMANI
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Credential | NP
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Telephone | 774-420-8961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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