MEDICARE: CAPE COD HEALTHCARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4312	OTHER	MA	DPH LICENSE

General Provider Information

NPI Number	:	1245286152
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPE COD HEALTHCARE INC.

Provider Business Mailing Address
First Line	:	460 W MAIN ST
Second Line	:
City	:	HYANNIS
State	:	MA
Zip	:	02601-3855
Country	:	US
Telephone Number	:	508-790-3360
Fax Number	:	508-790-3304

Provider Business Practice Location Address
First Line	:	460 W MAIN ST
Second Line	:
City	:	HYANNIS
State	:	MA
Zip	:	02601-3653
Country	:	US
Telephone Number	:	508-790-3360
Fax Number	:	508-790-3304

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DEBRA CIAVOLA
Credential	:	PHD
Telephone Number	:	508-862-5487

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	11/13/2025

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Directions to “CAPE COD HEALTHCARE INC. ” Practice Location

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