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General NPI Number Information
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NPI Number | 1992001457
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Entity Type | Organization
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Legal Business Name | MASHPEE SERVICE UNIT/INDIAN HEALTH SERVICE
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Dates
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Enumeration Date | 02/01/2011
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 483 GREAT NECK ROAD SOUTH BUILDING 002-HEALTH CLINIC
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City | MASHPEE
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State | MA
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Zip | 02649
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Country | US
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Telephone | 508-477-0209
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Fax | 508-477-1936
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Provider Business Mailing Address
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Address Line | 483 GREAT NECK ROAD SOUTH BUILDING 001-ADMIN BUILDING
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City | MASHPEE
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State | MA
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Zip | 02649
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Country | US
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Telephone | 508-477-0209
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Fax | 508-477-1936
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Authorized Official
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Title or Position | HEALTH SERVICE ADMINISTRATOR-CEO
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Name | MISS LORRAINE REELS-PEARSON
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Credential |
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Telephone | 508-477-6913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0904X
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Taxonomy Name | Federal Public Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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