=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760453328
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UHS OF WESTWOOD PEMBROKE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/31/2006
-----------------------------------------------------
Last Update Date | 06/07/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 45 CLAPBOARDTREE ST
-----------------------------------------------------
City | WESTWOOD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02090-2903
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-762-7764
-----------------------------------------------------
Fax | 781-255-8802
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 45 CLAPBOARDTREE ST
-----------------------------------------------------
City | WESTWOOD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02090-2903
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-762-7764
-----------------------------------------------------
Fax | 781-255-8802
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO SR VP
-----------------------------------------------------
Name | MR. STEVE FILTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 610-768-3300
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 283Q00000X
-----------------------------------------------------
Taxonomy Name | Psychiatric Hospital
-----------------------------------------------------
License Number | 690
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------