Healthcare Provider Details

I. General information

NPI: 1285599951
Provider Name (Legal Business Name): HOMETOWN BEHAVIORAL HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 MAIN ST STE 1
BUZZARDS BAY MA
02532-3285
US

IV. Provider business mailing address

243 MAIN ST STE 1
BUZZARDS BAY MA
02532-3285
US

V. Phone/Fax

Practice location:
  • Phone: 508-456-9892
  • Fax: 508-213-3697
Mailing address:
  • Phone: 508-456-9892
  • Fax: 508-213-3697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOLEEN CONNOLLY
Title or Position: PROVIDER/OWNER/EMPLOYEE
Credential: NP
Phone: 508-517-1169