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General NPI Number Information
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NPI Number | 1144340845
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Entity Type | Organization
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Legal Business Name | COMMONWEALTH OF MASSACHUSETTS-DMH
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 08/27/2007
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Provider Practice Location Address
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Address Line | 288 LYMAN ST
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City | WESTBOROUGH
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State | MA
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Zip | 01581-2633
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Country | US
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Telephone | 508-616-2805
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Fax |
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Provider Business Mailing Address
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Address Line | 288 LYMAN ST
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City | WESTBOROUGH
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State | MA
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Zip | 01581-2633
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Country | US
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Telephone | 508-616-2805
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Fax |
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Authorized Official
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Title or Position | SITE DIRECTOR
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Name | OSWALD RAMBARRAN
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Credential |
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Telephone | 508-616-2804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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