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General NPI Number Information
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NPI Number | 1720765175
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Entity Type | Organization
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Legal Business Name | D&T BEHAVIORAL HEALTH, LLC.
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Dates
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Enumeration Date | 06/28/2023
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 25 OLD WESTPORT RD
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City | NORTH DARTMOUTH
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State | MA
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Zip | 02747-2537
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Country | US
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Telephone | 508-802-5289
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Fax |
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Provider Business Mailing Address
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Address Line | 5 HIGHLAND CT
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City | WAREHAM
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State | MA
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Zip | 02571-1471
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Country | US
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Telephone | 508-558-6955
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANY MENARD
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Credential | LDAC I
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Telephone | 508-558-6955
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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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