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General NPI Number Information
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NPI Number | 1194844506
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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 | 03/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 40 INDUSTRIAL PARK RD
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City | PLYMOUTH
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State | MA
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Zip | 02360-4884
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Country | US
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Telephone | 508-732-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 25 STANIFORD ST
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City | BOSTON
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State | MA
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Zip | 02114-2503
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Country | US
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Telephone | 617-626-8000
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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 | MRS. LINDA LUNDIN
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Credential |
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Telephone | 508-732-3000
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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 | EXEMPT
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License Number State | MA
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