Healthcare Provider Details

I. General information

NPI: 1093714412
Provider Name (Legal Business Name): FIRST PSYCHIATRIC PLANNERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SOUTH ST
BROOKLINE MA
02467-3658
US

IV. Provider business mailing address

300 SOUTH ST
BROOKLINE MA
02467-3658
US

V. Phone/Fax

Practice location:
  • Phone: 617-469-0300
  • Fax: 617-469-5013
Mailing address:
  • Phone: 617-469-0300
  • Fax: 617-469-5013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number636
License Number StateMA

VIII. Authorized Official

Name: MR. MICHAEL C GALE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 617-469-0300