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General NPI Number Information
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NPI Number | 1528649126
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Entity Type | Organization
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Legal Business Name | HILLTOWN BEHAVIORAL HEALTH & SUBSTANCE ABUSE SERVICES HEALING H
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Dates
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Enumeration Date | 04/16/2021
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 241 WEST ST
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City | WORTHINGTON
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State | MA
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Zip | 01098-9618
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Country | US
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Telephone | 413-854-7096
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Fax |
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Provider Business Mailing Address
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Address Line | 241 WEST ST
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City | WORTHINGTON
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State | MA
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Zip | 01098-9618
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Country | US
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Telephone | 413-854-7096
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. TRACY SHERMAN MCMANMON SR.
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Credential | MSW, LICSW
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Telephone | 413-854-7096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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