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General NPI Number Information
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NPI Number | 1235949629
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Entity Type | Organization
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Legal Business Name | DECADES BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 99 DERBY ST STE 200
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City | HINGHAM
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State | MA
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Zip | 02043-4216
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Country | US
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Telephone | 508-216-0124
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Fax |
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Provider Business Mailing Address
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Address Line | 99 DERBY ST STE 200
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City | HINGHAM
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State | MA
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Zip | 02043-4216
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC MENTAL HEALTH NP
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Name | JACKIE AUDI
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Credential | NP
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Telephone | 781-205-0893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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