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General NPI Number Information
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NPI Number | 1134126865
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Entity Type | Organization
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Legal Business Name | BAY STATE COMMUNITY SERVICES, INC.
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 1120 HANCOCK ST
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City | QUINCY
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State | MA
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Zip | 02169-4313
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Country | US
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Telephone | 617-471-8400
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Fax | 617-376-0456
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Provider Business Mailing Address
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Address Line | 1120 HANCOCK ST
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City | QUINCY
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State | MA
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Zip | 02169-4313
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Country | US
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Telephone | 617-471-8400
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Fax | 617-376-0456
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Authorized Official
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Title or Position | CEO
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Name | DR. DAURICE COX
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Credential |
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Telephone | 617-471-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 0565
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 4337
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License Number State | MA
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