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General NPI Number Information
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NPI Number | 1154457422
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Entity Type | Organization
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Legal Business Name | PLYMOUTH COUNTY BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 81 SAMOSET ST
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City | PLYMOUTH
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State | MA
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Zip | 02360-4500
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Country | US
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Telephone | 85-830-0012
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Fax | 508-830-0092
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Provider Business Mailing Address
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Address Line | 81 SAMOSET ST
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City | PLYMOUTH
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State | MA
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Zip | 02360-4500
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Country | US
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Telephone | 508-830-0012
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATER
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Name | JULIE A JOHNSON
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Credential | PSYD
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Telephone | 508-830-0012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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