Provider Demographics
NPI:1144695420
Name:KENNEDY-DONOVAN CENTER, INC ABA SERVICES
Entity type:Organization
Organization Name:KENNEDY-DONOVAN CENTER, INC ABA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:AUBREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MACFARLANE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:508-772-1200
Mailing Address - Street 1:1 COMMERCIAL STREET
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035
Mailing Address - Country:US
Mailing Address - Phone:508-772-1270
Mailing Address - Fax:508-203-8717
Practice Address - Street 1:1 COMMERCIAL STREET
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035
Practice Address - Country:US
Practice Address - Phone:508-772-1270
Practice Address - Fax:508-203-8717
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KENNEDY-DONOVAN CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA95103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty