| Broad Meadow Cooperative Llc | |
|
7 Cuba St Andover MA 01810-3407 | |
| (978) 494-4460 | |
| Not Available |
| Full Name | Broad Meadow Cooperative Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 7 Cuba St, Andover, Massachusetts |
| Authorized Official Name and Position | Bradley Thomas Eardley (OWNER) |
| Authorized Official Contact | 9784944460 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broad Meadow Cooperative Llc 7 Cuba St Andover MA 01810-3407 Ph: (978) 494-4460 | Broad Meadow Cooperative Llc 7 Cuba St Andover MA 01810-3407 Ph: (978) 494-4460 |
| NPI Number | 1760178453 |
|---|---|
| Provider Enumeration Date | 04/14/2023 |
| Last Update Date | 04/14/2023 |
| Certification Date | 04/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760178453 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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