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General NPI Number Information
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NPI Number | 1356280382
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Entity Type | Organization
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Legal Business Name | BAYCOVE
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 170 MORTON ST FL 4
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City | JAMAICA PLAIN
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State | MA
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Zip | 02130-3735
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Country | US
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Telephone | 617-318-5600
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Fax | 617-983-4917
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Provider Business Mailing Address
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Address Line | 170 MORTON ST FL 4
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City | JAMAICA PLAIN
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State | MA
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Zip | 02130-3735
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Country | US
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Telephone | 617-318-5600
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Fax | 617-983-4917
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Authorized Official
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Title or Position | INTAKE COORDINATOR
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Name | MS. STACEY ANN PENTZ
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Credential |
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Telephone | 618-318-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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