NPI Code Details Logo

NPI 1083554695

NPI 1083554695 : PBH OXFORD LLC : OXFORD, MA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1083554695
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    PBH OXFORD LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    03/31/2026
-----------------------------------------------------
    Last Update Date     |    04/02/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    245 MAIN ST 
-----------------------------------------------------
    City                 |    OXFORD
-----------------------------------------------------
    State                |    MA
-----------------------------------------------------
    Zip                  |    01540-2338
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    508-690-4767
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    245 MAIN ST 
-----------------------------------------------------
    City                 |    OXFORD
-----------------------------------------------------
    State                |    MA
-----------------------------------------------------
    Zip                  |    01540-2338
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    508-690-4767
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    EXECUTIVE DIRECTOR
-----------------------------------------------------
    Name                 |     JARED  STANLEY 
-----------------------------------------------------
    Credential           |    LADC
-----------------------------------------------------
    Telephone            |    781-382-8201
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QM0850X
-----------------------------------------------------
    Taxonomy Name        |    Adult Mental Health Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.