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NPI Code Detail

MEDICARE: NEW BEDFORD COUNSELING GROUP INC

MEDICARE: NEW BEDFORD COUNSELING GROUP 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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1316494487
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW BEDFORD COUNSELING GROUP INC
Provider Business Mailing Address
First Line : 131 WILLIS ST
Second Line : APT 1
City : NEW BEDFORD
State : MA
Zip : 02740
Country : US
Telephone Number : 508-617-3643
Fax Number :
Provider Business Practice Location Address
First Line : 306 MOUNT PLEASANT ST
Second Line :
City : NEW BEDFORD
State : MA
Zip : 02746-1539
Country : US
Telephone Number : 508-617-3643
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. MICHAEL CRAIG FRIAS
Credential :
Telephone Number : 508-617-3643
Provider Enumeration Date : 09/07/2016
Last Update Date : 01/05/2017

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