Provider Demographics
NPI:1053589507
Name:GARDNER GROUP, INC.
Entity type:Organization
Organization Name:GARDNER GROUP, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:STVARTAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-632-3518
Mailing Address - Street 1:PO BOX 1031
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-6031
Mailing Address - Country:US
Mailing Address - Phone:978-632-3518
Mailing Address - Fax:978-630-3987
Practice Address - Street 1:216 MILL ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-3293
Practice Address - Country:US
Practice Address - Phone:978-632-3518
Practice Address - Fax:978-630-3987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty