Healthcare Provider Details

I. General information

NPI: 1467507293
Provider Name (Legal Business Name): BEHAVIORAL HEALTH NETWORK, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 LIBERTY ST
SPRINGFIELD MA
01104-3779
US

IV. Provider business mailing address

PO BOX 2738
SPRINGFIELD MA
01101-2738
US

V. Phone/Fax

Practice location:
  • Phone: 413-301-9403
  • Fax: 413-732-7075
Mailing address:
  • Phone: 413-747-0705
  • Fax: 413-732-7075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RICHARD FOLLETT
Title or Position: VP OF ADMINISTRATION
Credential:
Phone: 413-519-9495