Healthcare Provider Details

I. General information

NPI: 1447957519
Provider Name (Legal Business Name): KOBBEX BEHAVIORAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2023
Last Update Date: 10/11/2025
Certification Date: 10/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 W BOYLSTON ST
WEST BOYLSTON MA
01583-1779
US

IV. Provider business mailing address

12 W BOYLSTON ST
WEST BOYLSTON MA
01583-1779
US

V. Phone/Fax

Practice location:
  • Phone: 888-690-9039
  • Fax:
Mailing address:
  • Phone: 888-690-9039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. EXTA OPPONG TWENEBOA
Title or Position: PRESIDENT
Credential: NP
Phone: 888-690-9039