=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386520419
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SANGO BEHAVIORAL HEALTH & HOME HEALTH SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/13/2025
-----------------------------------------------------
Last Update Date | 08/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25 WINTHROP TER
-----------------------------------------------------
City | WARREN
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01083-9791
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-371-7441
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 32 DEERFIELD RD # 25
-----------------------------------------------------
City | SHREWSBURY
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01545-1530
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-371-7441
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PMHNP
-----------------------------------------------------
Name | MISPA S SANGO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 508-371-7441
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------