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General NPI Number Information
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NPI Number | 1518794262
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Entity Type | Organization
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Legal Business Name | FLAGSHIP MENTAL HEALTH, LLC
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Dates
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Enumeration Date | 09/17/2024
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 1200 HIGH RIDGE RD
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City | STAMFORD
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State | CT
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Zip | 06905-1223
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Country | US
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Telephone | 781-929-0789
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Fax |
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Provider Business Mailing Address
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Address Line | 8 ESSEX CENTER DR # 301
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City | PEABODY
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State | MA
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Zip | 01960-2959
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Country | US
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Telephone | 978-737-7937
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Fax |
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Authorized Official
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Title or Position | VP OPERATIONS
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Name | KRYSTIN QUINN
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Credential |
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Telephone | 978-737-7937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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