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General NPI Number Information
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NPI Number | 1770528317
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Entity Type | Organization
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Legal Business Name | SOUTH SHORE MENTAL HEALTH CENTER, INC.
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 460 QUINCY AVE
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City | QUINCY
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State | MA
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Zip | 02169-8130
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Country | US
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Telephone | 617-847-1950
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 WASHINGTON ST
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City | BRAINTREE
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State | MA
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Zip | 02184-7599
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Country | US
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Telephone | 617-847-1950
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Fax | 617-786-9894
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MINGHUI JOHNSON
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Credential |
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Telephone | 617-847-1950
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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 | 459
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 459
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License Number State | MA
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