| Black Behavioral Health Network Incorporated | |
|
287 State St Springfield MA 01105-1812 | |
| (866) 462-2461 | |
| Not Available |
| Full Name | Black Behavioral Health Network Incorporated |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 287 State St, Springfield, Massachusetts |
| Authorized Official Name and Position | Della R Blake (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4133483452 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Behavioral Health Network Incorporated 287 State St Springfield MA 01105-1812 Ph: (413) 348-3452 | Black Behavioral Health Network Incorporated 287 State St Springfield MA 01105-1812 Ph: (866) 462-2461 |
| NPI Number | 1598531055 |
|---|---|
| Provider Enumeration Date | 11/27/2023 |
| Last Update Date | 01/22/2024 |
| Certification Date | 01/22/2024 |
| Medicare PECOS PAC ID | 8729427281 |
|---|---|
| Medicare Enrollment ID | O20240416003510 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598531055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Della Blake |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639935240 PECOS PAC ID: 9931540754 Enrollment ID: I20240510002355 |
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