Provider Demographics
NPI:1063765337
Name:DEPARTMENT OF DEVELOPEMENTAL SERVICES
Entity type:Organization
Organization Name:DEPARTMENT OF DEVELOPEMENTAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MUARRAY
Authorized Official - Suffix:
Authorized Official - Credentials:DIRECTOR OF NURSING
Authorized Official - Phone:978-774-5000
Mailing Address - Street 1:450 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-4009
Mailing Address - Country:US
Mailing Address - Phone:978-774-5000
Mailing Address - Fax:
Practice Address - Street 1:450 MAPLE ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-4009
Practice Address - Country:US
Practice Address - Phone:978-774-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN256544251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health